WADE D REYNOLDS DO, LLC (NPI# 1518217389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518217389 |
| Entity Type | Organization |
| Organization Name | WADE D REYNOLDS DO, LLC |
| Other Organization Name | IVY PARK FAMILY MEDICINE |
| Practice Address |
111 Ivy Park Ln Suite C Lexington SC 29072-8289 |
| Mailing Address |
111 Ivy Park Lane Suite C Lexington SC 29072-8289 |
| Practice Telephone | 8037854555 |
| Practice Fax Number | 8037854556 |
| Mailing Telephone | 8037854555 |
| Mailing Fax Number | 8037854556 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |
| Authorized Official Name | DR. WADE REYNOLDS (PRESIDENT) |
| Authorized Official Telephone | 8037854555 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0417 | SC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ivy Park Family Medicine | Doing Business As Name - Organization |
| Street Address |
111 IVY PARK LN SUITE C |
| City | LEXINGTON |
| State | SC |
| Zip Code | 29072-8289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1730727629 | Erika Watts | Occupational Therapist | 100 Tarrar Springs Road, Sped, Lexington, SC 29072 | 2019-12-11 |
| 1194380600 | Lexington County Health Services District, Inc. | Clinic/Center | 154 Saluda Pointe Ct, Lexington, SC 29072 | 2019-05-09 |
| 1962973768 | William R. Key | Counselor | Lexington Community Mental Health Center, 301 Palmetto Park Boulevard, Lexington, SC 29072 | 2018-12-06 |
| 1639651961 | Lindsey Terry | Social Worker | 108 Palmetto Pk. Boulveard, Suite D, Lexington, SC 29072 | 2018-09-04 |
| 1922594126 | Dental Professional of South Carolina, P.C. | Dentist | 2448 Augusta Hwy, Lexington, SC 29072 | 2018-07-11 |
| 1598251605 | Lynn Marceline Beckett-lowe | Nurse Practitioner | 124 Pink Camellia Lane, Lexington, SC 29072 | 2018-07-02 |
| 1083120620 | Diana Reiss | Counselor | 714 S Lake Drive, 120, Lexington, SC 29072 | 2017-12-19 |
| 1649781857 | Constance Jean Lynch | Occupational Therapist | 800 North Lake Boulevard, Lexington, SC 29072 | 2017-10-14 |
| Find all providers in zip 29072 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809108 | Lexington Primary Care LLC | Clinic/Center | 777 Athens Rd, Lexington, GA 30648-1902 | 2020-10-20 |
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1467908095 | Careatc - Leggett & Platt - Lexington, Nc | Clinic/Center | 3040 Junior Order Home Road, Lexington, NC 27292 | 2016-09-01 |
| 1023266509 | Family First Medical Clinic | Clinic/Center | 21 W Church St, Lexington, TN 38351-2009 | 2008-09-08 |
| 1013905710 | Transsouth Healthcare PC | Clinic/Center | 120 E Church St, Lexington, TN 38351-1821 | 2005-10-07 |
| 1104459502 | Chevy Chase Primary Care LLC | Clinic/Center | 330 Romany Rd, Lexington, KY 40502-2404 | 2020-02-14 |
| 1538527254 | Viphealth LLC | Clinic/Center | 117 Park Place Ct, Lexington, SC 29072-6690 | 2016-02-09 |
| 1952736035 | Cotton Grove Family Physicians, Pllc | Clinic/Center | 1926 Cotton Grove Rd, Lexington, NC 27292-5722 | 2013-09-09 |
| Find all providers in LEXINGTON | ||||
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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.