MR. DENNIS ELROY REYNOLDS (NPI# 1366638553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366638553 |
Entity Type | Individual |
Full Name | MR. DENNIS ELROY REYNOLDS |
Credential | MD |
Practice Address |
3995 Marcola Road Springfield OR 97477 |
Mailing Address |
367 Rees Hill Rd Se Salem OR 97306 |
Practice Telephone | 5417261465 |
Practice Fax Number | 5417265085 |
Mailing Telephone | 5033997083 |
Mailing Fax Number | 5033997083 |
Enumeration Date | 2007-09-20 |
Last Update Date | 2007-09-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD12514 | OR | Allopathic & Osteopathic Physicians |
Street Address |
3995 MARCOLA ROAD |
City | SPRINGFIELD |
State | OR |
Zip Code | 97477 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013099522 | James Tomasevich | Counselor | 3995 Marcola Road, Springfield, OR 97477 | 2006-10-20 |
1992275580 | Kayleen Patricia Knutson | Behavioral Analyst | 3995 Marcola Road, Springfield, OR 97477 | 2018-11-27 |
1881123610 | Sierra Emily Gerhard | Behavioral Analyst | 3995 Marcola Road, Springfield, OR 97477 | 2017-06-06 |
1669760401 | Katie Lee Stoneberg | Counselor | 3995 Marcola Road, Springfield, OR 97477 | 2011-07-14 |
1528397494 | Tony Lavon Smith Jr. | Counselor | 3995 Marcola Road, The Child Center, Springfield, OR 97477 | 2009-12-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
Find all providers in zip 97477 |
Taxonomy Code | 2084P0804X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Child & Adolescent Psychiatry |
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104234046 | Hitekshya Nepal | Psychiatry & Neurology | 5230 6th Street Frontage Rd E, Springfield, IL 62703-5128 | 2014-07-23 |
1700931433 | Purificacion Geronimo-flores | Psychiatry & Neurology | Mspcc, 235 Chestnut Street, Springfield, MA 01103 | 2007-01-24 |
1073607495 | Hayley Marks Cohen | Psychiatry & Neurology | 28 Millburn Avenue, Suite 3, Springfield, NJ 07081 | 2006-10-02 |
1679841381 | Rashi Govil | Psychiatry & Neurology | 417 Liberty St, Behavioral Health Network, Inc., Springfield, MA 01104-3736 | 2011-12-08 |
1174838452 | Nasir Iqbal Ahmad | Psychiatry & Neurology | 5220 S 6th Street Rd, Suite 1200, Springfield, IL 62703-5735 | 2010-08-11 |
1912138660 | Othman M Mohammad | Psychiatry & Neurology | 3300 Main St Fl 4, Springfield, MA 01107-1112 | 2009-07-29 |
1235382771 | David J Wood Md Frcpc,pc | Psychiatry & Neurology | 6551 Loisdale Ct, Suite 155, Springfield, VA 22150-1828 | 2008-10-28 |
1790982668 | Zafar Abdur Rasheed | Psychiatry & Neurology | 8348 Traford Ln, 4th Floor, Springfield, VA 22152-1663 | 2007-07-02 |
1912053877 | Nathan P Somers | Psychiatry & Neurology | 3300 Main St, Springfield, MA 01107-1112 | 2007-01-25 |
1093871261 | Baystate Medical Practices, Inc | Psychiatry & Neurology | 759 Chestnut St, Springfield, MA 01199-1001 | 2006-12-29 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 97477 |
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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.