Active NPI
Robert William Reynolds, RT(R)(T)
- Radiation Therapy Radiologic Technologist
- Hershey, PA
National Provider Identifier
1992820740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Therapy Radiologic Technologist
- License
- 207055
- Practice address
- 500 University Dr
Hershey, PA 17033-2360 - Phone
- (717) 531-4889
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Therapy Radiologic Technologist | 2471R0002X | 207055 | PA | Primary |
| Radiation Therapy Radiologic Technologist | 2471R0002X | T1854925 | OH | |
| Radiation Therapy Radiologic Technologist | 2471R0002X | 261258 | NY |
Addresses
Primary practice location
500 University Dr
Hershey, PA 17033-2360
Mailing address
340 Craig St
Erie, PA 16508-2710
Phone (814) 452-4429
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 261258 | NY | MD | Radiation Therapy Radiologic Technologist |
| T1854925 | OH | MD | Radiation Therapy Radiologic Technologist |
| 207055 | PA | MD | Radiation Therapy Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992820740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 CRAIG ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165082710",
"telephone_number": "814-452-4429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 UNIVERSITY DR",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170332360",
"telephone_number": "717-531-4889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "RT(R)(T)",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2471R0002X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiation Therapy",
"state": "PA",
"license": "207055",
"primary": true
},
{
"code": "2471R0002X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiation Therapy",
"state": "OH",
"license": "T1854925",
"primary": false
},
{
"code": "2471R0002X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiation Therapy",
"state": "NY",
"license": "261258",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hershey, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.