Individual provider Active NPI

Linda Hyunjin McReynolds, PA-C

  • Physician Assistant
  • Edgewood, KY
National Provider Identifier
1942689229
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2371 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-8074
Fax
(859) 301-4945
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005618RX OH
Physician Assistant 363A00000X PA2371 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 635283
Cincinnati, OH 45263-8962
Phone (859) 301-8074

Other practice location 1

10582 Loveland Madeira Rd
Loveland, OH 45140-8962
Phone (513) 677-2400

Other practice location 2

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, OH, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170803002678 SC Practitioner - Physician Assistant 5496065872 Reassigns benefits to 1 organization
I20181204002711 OH Practitioner - Physician Assistant 5496065872 Reassigns benefits to 4 organizations
I20200217000944 KY Practitioner - Physician Assistant 5496065872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-5901

238 Barnes Rd
Williamstown, KY 41097-9482
Phone (859) 212-4467

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-4625

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 301-5901

PO Box
Suite 635283
Cincinnati, OH 45263-5283

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Feb 20, 2020 Accepting new patients
Summit Medical Group, Inc Physician Assistant CurrentSince Feb 20, 2020 Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Organizations & group practices 7

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 3

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": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1942689229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638962",
            "telephone_number": "859-301-8074",
            "fax_number": "859-301-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-8074",
            "fax_number": "859-301-4945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10582 Loveland Madeira Rd",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "OH",
            "postal_code": "451408962",
            "country_code": "US",
            "telephone_number": "513-677-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "LINDA",
        "middle_name": "HYUNJIN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005618RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.