DR. SUSAN KIM REYNOLDS (NPI# 1700877032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700877032 |
| Entity Type | Individual |
| Full Name | DR. SUSAN KIM REYNOLDS |
| Credential | MD |
| Practice Address |
1215 Vandalia St Collinsville IL 62234-4060 |
| Practice Telephone | 6183436015 |
| Practice Fax Number | 6185785759 |
| Mailing Telephone | 6183436015 |
| Mailing Fax Number | 6185785759 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2018-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036-126550 | IL | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | R5E07 | MO | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036126550 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R5E07 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1700877032 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467060012 | Susan Reynolds | Marriage & Family Therapist | 3380 Monroe Ave Ste 117, Rochester, NY 14618-4726 | 2020-07-20 |
| 1598180127 | Susan Reynolds | Licensed Psychiatric Technician | 3904 Jane Way, Modesto, CA 95356-0825 | 2014-02-18 |
| 1417298233 | Susan Reynolds | Physical Therapist | 6777 Sterling Creek Rd, Jacksonville, OR 97530-8920 | 2013-03-04 |
| 1396081790 | Susan Nelson Reynolds | Speech-Language Pathologist | 2405 S 300th St, Federal Way, WA 98003-4225 | 2012-12-13 |
| 1184968752 | Susan Marie Reynolds | Massage Therapist | 3010 S. Southeast Blvd, Suite A, Spokane, WA 99223 | 2012-11-20 |
| 1154459287 | Susan Jean Reynolds | Nurse Practitioner | 9802 Woodbury Ave, Garden Grove, CA 92844-2819 | 2007-03-01 |
| 1184785404 | Susan Foster Reynolds | Emergency Medicine | 652 Jacon Way, Pacific Palisades, CA 90272-2827 | 2006-12-12 |
| 1033202585 | Susan Reynolds | Social Worker | 4601 Excelsior Blvd Ste 400, St Louis Park, MN 55416-4977 | 2006-10-02 |
| 1780170902 | Susan Reynolds | Audiologist | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-07-11 |
| 1144733007 | Susan Marie Reynolds | Family Medicine | 830 S Main St, Orrville, OH 44667-2291 | 2017-11-14 |
| Street Address |
1215 VANDALIA ST |
| City | COLLINSVILLE |
| State | IL |
| Zip Code | 62234-4060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427515576 | Maria Andrea Cuartas | Physician Assistant | 1215 Vandalia St, Collinsville, IL 62234-4060 | 2019-02-25 |
| 1831483577 | Khaola Shalabi | Counselor | 1215 Vandalia St, Collinsville, IL 62234 | 2011-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791005 | Kendall Kotter | Pharmacist | 401 Beltline Rd, Collinsville, IL 62234 | 2020-08-18 |
| 1851804207 | Apex Physical Therapy, LLC | Clinic/Center | 1095 Beltine Rd., Ste. 400, Collinsville, IL 62234 | 2017-11-08 |
| 1205361110 | Pc Associates, LLC | Family Medicine | 1095 Beltline Road, Suite 500, Collinsville, IL 62234 | 2017-04-28 |
| 1538405451 | Joan M Polwort | Pharmacist | 801 Braidwood Ct, Collinsville, IL 62234 | 2012-12-20 |
| 1275818080 | Stephen Scott Branding | Pharmacist | 401 Beltline Rd., Collinsville, IL 62234 | 2011-10-13 |
| 1447534417 | Lindsay Eakin | Pharmacist | 401 Beltline, Collinsville, IL 62234 | 2011-10-07 |
| 1700171568 | Patrick Joseph Swierczek | Social Worker | 820 St. Louis Rd Apt#232, Collinsville, IL 62234 | 2011-06-09 |
| 1366670887 | Susan M. Smith Dc LLC | Chiropractor | 226 South Morrison, Collinsville, IL 62234 | 2009-06-23 |
| 1649418492 | Lynette M Patton | Counselor | 415 W Main St Ste 3, Collinsville, IL 62234 | 2009-02-02 |
| 1558506626 | Kimberly Jean Miller | Counselor | Meadow Heights Professional Park, Suite 2b, Collinsvile, IL 62234 | 2008-12-03 |
| Find all providers in zip 62234 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205361110 | Pc Associates, LLC | Family Medicine | 1095 Beltline Road, Suite 500, Collinsville, IL 62234 | 2017-04-28 |
| 1982917183 | Pc Associates, LLC | Family Medicine | 501 Beltline Road, Ste 20-d, Collinsville, IL 62234-4410 | 2010-07-16 |
| 1669566527 | Frances H. Koe | Family Medicine | 52 S Valley Ave, Collinsville, AL 35961-3263 | 2006-10-03 |
| 1194749218 | Patrick Zimmermann | Family Medicine | 531 Vandalia St, Suite 100, Collinsville, IL 62234-4061 | 2006-07-26 |
| 1477506426 | Joseph Michael Corvallis | Family Medicine | 101 Saint Louis Rd, Collinsville, IL 62234-2450 | 2006-05-19 |
| 1346222890 | Edward Daniel Henderson Jr. | Family Medicine | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2005-11-18 |
| 1801890454 | Jerry D. Patton | Family Medicine | 1205 W Main St, Collinsville, OK 74021-3114 | 2005-06-10 |
| 1902450281 | Pamela Shirley | Family Medicine | 52 S Valley Ave Ste B, Collinsville, AL 35961-3263 | 2019-07-25 |
| 1013432244 | Fort Payne Rhc Corp | Family Medicine | 13280 County Road 51, Collinsville, AL 35961-4174 | 2017-08-09 |
| 1073035051 | Fort Payne Clinic Corp | Family Medicine | 13280 County Road 51, Collinsville, AL 35961-4174 | 2017-07-12 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 62234 |
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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.