Individual provider Active NPI

F Douglas Reynolds, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Hampden, ME
National Provider Identifier
1962483719
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD 181 Issued in ME
Practice address
739 Western Ave
Hampden, ME 04444-1036
Phone
(207) 947-2220
Fax
(207) 947-4073
NPI assigned
Nov 9, 2005
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD 181 ME
Radiology Podiatrist 213ER0200X POD 181 ME
Sports Medicine Podiatrist 213ES0000X POD 181 ME
Foot & Ankle Surgery Podiatrist 213ES0103X POD 181 ME Primary

Addresses

Primary practice location

739 Western Ave
Hampden, ME 04444-1036

Mailing address

739 Western Ave
Hampden, ME 04444-1036
Phone (207) 944-8152

Other identifiers 1

IdentifierTypeStateIssuer
126420099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD 181MEMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Foot & Ankle, PA Foot & Ankle Surgery Current Accepting new patients

Locations

33 Penn Plz
#A
Bangor, ME 04401
Phone (207) 941-0080

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1962483719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 WESTERN AVE",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441036",
            "telephone_number": "207-944-8152",
            "fax_number": "207-862-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 WESTERN AVE",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441036",
            "telephone_number": "207-947-2220",
            "fax_number": "207-947-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "F",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD 181",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "ME",
            "license": "POD 181",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "ME",
            "license": "POD 181",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ME",
            "license": "POD 181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126420099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampden, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.