Gerald Edward Reynolds, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0003577 Issued in FL

Practice address

4685 N Highway 19a
Mount Dora, FL 32757-2039

Phone

(352) 589-5900

Fax

(352) 589-5904

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jerry E Reynolds Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1942392873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SE 167TH PLACE RD",
            "address_2": "SUITE 5-1",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918686",
            "telephone_number": "352-307-9925",
            "fax_number": "352-347-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572039",
            "telephone_number": "352-589-5900",
            "fax_number": "352-589-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "GERALD",
        "middle_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0003577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038568900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080130087",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "REYNOLDS",
            "middle_name": "E",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Restore Health Services Inc
• Grisbel M Reyes-Cruz, RBT
• Carlos Reyes
• Paola Maria Reyes
• Reynolds Owens Enterprises, LLC
• Ricardo L. Duran D.D.S., M.S.,P.a.
• Sara Joy Richards, OTR
• Camryn Richardville
• Makenzie Riggins, RBT
• Justin Riller

• Family Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.