Individual provider Active NPI

Casey Lee Reynolds, NP

  • Critical Care Medicine Nurse Practitioner
  • Marquette, MI
National Provider Identifier
1932775236
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
4704279943 Issued in MI
Practice address
850 W Baraga Ave
Marquette, MI 49855-4550
Phone
(906) 449-1270
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704279943 MI
Critical Care Medicine Nurse Practitioner 363LC0200X 4704279943 MI Primary

Addresses

Primary practice location

850 W Baraga Ave
Marquette, MI 49855-4550

Mailing address

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-1270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917002677 MI Practitioner - Nurse Practitioner 0547667586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704279943MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Aug 17, 2021 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Aug 17, 2021 Accepting new patients

Locations

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

850 W Baraga Ave
Ste 31
Marquette, MI 49855
Phone (906) 449-3600

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: casey.reynolds.1@8233.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1932775236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CASEY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704279943",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MI",
            "license": "4704279943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.