Mark Edward Reynolds, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-058792 Issued in OH

Practice address

3095 Kettering Blvd
Moraine, OH 45439-1983

Phone

(937) 293-8300

Fax

(937) 534-1579

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Marl E Reynolds MD Inc

  • Psychiatry Physician
  • Bellbrook, OH
  • NPI 1245568963
  NPD (past) Authorized official
• Maier Psychological Services LTD

  • Clinical Psychologist
  • Cincinnati, OH
  • NPI 1467630095
  NPD (past)
• Premier Heart Associates, Inc

  • Cardiovascular Disease Physician
  • Beavercreek, OH
  • NPI 1538188735
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1992857437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300",
            "fax_number": "937-534-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300",
            "fax_number": "937-534-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-058792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Reier
• Vicki Reiner
• Virginia Ann Reinhard
• Morgan Rench
• Catherine Anne Renfrow, MSED, LPCC-S
• Lisa A Rhodes, CNP
• Sarah E Rhodes, MA, LPCC-S
• Brianna Danielle Rice
• Kirstyn Joanne Richards
• Olivia M Rickard

• Psychiatry Physician in Moraine, OH
• Providers in Moraine, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.