REYNOLDS PLASTIC SURGERY LLC (NPI# 1336300466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336300466 |
| Entity Type | Organization |
| Organization Name | REYNOLDS PLASTIC SURGERY LLC |
| Practice Address |
1531 E Bradford Pkwy Suite 215 Springfield MO 65804-6566 |
| Practice Telephone | 4178239777 |
| Practice Fax Number | 4178239731 |
| Mailing Telephone | 4178239777 |
| Mailing Fax Number | 4178239731 |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2019-11-22 |
| Authorized Official Name | DR. WILLIAM R REYNOLDS (PHYSICIAN) |
| Authorized Official Telephone | 4178239777 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 107745 | MO | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 201291408 | 05 |
| Street Address |
1531 E BRADFORD PKWY SUITE 215 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667208 | Bradford Place Surgery and Laser Center LLC | Clinic/Center | 1531 E Bradford Pkwy, Ste 120, Springfield, MO 65804-6539 | 2005-05-27 |
| 1114292919 | Kimberly Ann Ramacciotti | Counselor | 1531 E Bradford Pkwy, Suite 304, Springfield, MO 65804-6566 | 2012-03-13 |
| 1184915472 | Creative Renewal & Resolutions, LLC | Psychologist | 1531 E Bradford Pkwy, Ste 210-4, Springfield, MO 65804-6566 | 2011-04-21 |
| 1033427810 | Renae Marie Courtney | Psychologist | 1531 E Bradford Pkwy, Suite 304, Springfield, MO 65804-6566 | 2010-09-15 |
| 1760793483 | Diderika M Telting | Speech-Language Pathologist | 1531 E Bradford Pkwy, Suite 205, Springfield, MO 65804-6853 | 2010-06-28 |
| 1801097951 | N Eugene Morrow Md LLC | Dermatology | 1531 E Bradford Pkwy, Suite 215, Springfield, MO 65804-6539 | 2007-05-29 |
| 1144277252 | Missouri Eye Institute LLC | Optometrist | 1531 E Bradford Pkwy, Suite 100, Springfield, MO 65804-6566 | 2006-05-27 |
| 1568433886 | Kathleen F Lemon | Psychologist | 1531 E Bradford Pkwy, Ste 210-1, Springfield, MO 65804-6856 | 2006-01-27 |
| 1184695496 | Ginger A Holczer | Psychologist | 1531 E Bradford Pkwy, Suite 202, Springfield, MO 65804-6566 | 2006-01-27 |
| 1093701211 | Daniel R Osborn | Ophthalmology | 1531 E Bradford Pkwy, Suite 100, Springfield, MO 65804-6566 | 2005-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518313287 | Prairie Bleeding and Clotting Center | Specialist | 105 S Amos Ave, Springfield, IL 62704-1528 | 2016-05-11 |
| 1043666894 | Nina Olmeda | Specialist | 35 Braywood Cir, Springfield, MA 01151-1036 | 2016-05-11 |
| 1144681214 | Vickiejean Phillips | Specialist | 1332 35th St, Springfield, OR 97478-5554 | 2016-03-16 |
| 1811354681 | Monica M Jones | Specialist | 118 Victory Rd Apt 315, Springfield, NJ 07081-1342 | 2016-01-25 |
| 1215334941 | Brandon Avenue Pediatrics | Specialist | 6126 Brandon Ave, Springfield, VA 22150-2610 | 2014-11-24 |
| 1558766006 | Ozark Retina & Macula | Specialist | 1230 E Kingsley St Ste A, Springfield, MO 65804-7231 | 2014-10-27 |
| 1396146411 | Colin Bailey | Specialist | 155 S Tuttle Rd, Springfield, OH 45505-1560 | 2014-09-08 |
| 1659771350 | Ronnie L. Jackson Md | Specialist | 496 Northcrest Dr, Springfield, TN 37172-3972 | 2014-08-29 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.