SHANE REYNOLDS (NPI# 1780079269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780079269 |
| Entity Type | Individual |
| Full Name | SHANE REYNOLDS |
| Credential | DPM |
| Practice Address |
488 Main Ave Norwalk CT 06851-1008 |
| Practice Telephone | 2038380442 |
| Mailing Telephone | 2038380442 |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2020-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 001009 | CT | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295161735 | Shane Edward Reynolds | Hearing Instrument Specialist | 3810 S Cooper St, Suite 144, Arlington, TX 76015-4149 | 2013-09-16 |
| 1285727859 | Shane E Reynolds | Physician Assistant | 7615 W Thunderbird Rd, Ste 106, Peoria, AZ 85381-6083 | 2006-10-02 |
| Street Address |
488 MAIN AVE |
| City | NORWALK |
| State | CT |
| Zip Code | 06851-1008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184809253 | Marisa Kim Dematteo-santa | Podiatrist | 488 Main Ave, Norwalk, CT 06851-1008 | 2008-01-08 |
| 1740636760 | Norwalk Sports & Spine | Chiropractor | 488 Main Ave, 2nd Floor, Norwalk, CT 06851-1008 | 2016-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763434 | Cynthia Eliezer | Student in an Organized Health Care Education/Training Program | 120 East Ave 2nd Flr., Norwalk, CT 06851 | 2016-11-18 |
| 1356897672 | Be Balanced Naturopathic Care Center, LLC | Naturopath | 91 East Ave, Garden Level, Norwalk, CT 06851 | 2016-08-28 |
| 1861843559 | Valerie Andree Vincent | Student in an Organized Health Care Education/Training Program | 120 East Avenue-2nd Floor, Catholic Charities, Norwalk, CT 06851 | 2016-06-24 |
| 1417333758 | Laura Rebecca Nierenberg Fishman | Marriage & Family Therapist | 161 East Avenue, Suite 101, Norwalk, CT 06851 | 2015-08-10 |
| 1487085411 | Danielle Christine Boland | Social Worker | 206 Wolfpit Avenue, Norwalk, CT 06851 | 2013-12-02 |
| 1427485846 | Michelle Clement | Technician/Technologist | 650 Main Avenue, Norwalk, CT 06851 | 2013-09-30 |
| 1932447430 | Rebecca Roessler Velasquez | Social Worker | 225 W Rocks Rd, Norwalk, CT 06851 | 2013-01-18 |
| 1275809154 | Tiffany A. Mccarty | Social Worker | 166 East Ave Ste 204, Norwalk, CT 06851 | 2012-03-26 |
| 1356573547 | Cheree Louise Fenske | Clinical Neuropsychologist | 761 Main Ave Ste 104, Norwalk, CT 06851 | 2009-08-20 |
| 1083869572 | Carol Lynne Cooper | Obstetrics & Gynecology | 17 North Ave., Norwalk, CT 06851 | 2008-11-25 |
| Find all providers in zip 06851 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063416683 | Lonnie Neil Resnick Ix | Podiatrist | 83 East Ave, Ste 313, Norwalk, CT 06851-4902 | 2005-06-10 |
| 1396264875 | Harris Greenberger | Podiatrist | 4 Colony St, Norwalk, CT 06851-5803 | 2017-09-15 |
| 1750557575 | Michael D. Mcgavic, A Professional Corporation | Podiatrist | 13132 Studebaker Rd, Suite #2, Norwalk, CA 90650-2557 | 2008-05-01 |
| 1417132234 | Marvin Ginsberg, D.p.m. | Podiatrist | 111 East Ave, Suite 317, Norwalk, CT 06851-5014 | 2007-12-31 |
| 1790965176 | James Revelas, D.p.m. | Podiatrist | 64 Executive Dr, Norwalk, OH 44857-9568 | 2007-11-14 |
| 1063449874 | David G Bartis | Podiatrist | 13132 Studebaker Rd, Suite #10, Norwalk, CA 90650-2557 | 2006-06-27 |
| 1780624544 | Rebecca S Rogoff | Podiatrist | 13132 Studebaker Rd, Suite #10, Norwalk, CA 90650-2557 | 2006-06-08 |
| 1831146893 | Peter Dai Dang | Podiatrist | 11401 South Bloomfield Avenue, Norwalk, CA 90650 | 2006-05-27 |
| 1457345803 | Devang C Patel | Podiatrist | 761 Main Ave, Suite 106, Norwalk, CT 06851-1080 | 2005-08-31 |
| 1023019619 | Harris A Greenberger | Podiatrist | 4 Colony St, Norwalk, CT 06851-5803 | 2005-08-03 |
| Find all providers in NORWALK | ||||
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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.