MERRICK GORDON REYNOLDS


Address: 526 Shoup Ave W, Suite E, Twin Falls, ID 83301-5050
Phone: 2087331112

MERRICK GORDON REYNOLDS (NPI# 1891097234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891097234
Entity Type Individual
Full Name MERRICK GORDON REYNOLDS
Credential PA
Practice Address 526 Shoup Ave W
Suite E
Twin Falls
ID 83301-5050
Practice Telephone 2087331112
Practice Fax Number 2087321212
Mailing Telephone 2087331112
Mailing Fax Number 2087321212
Enumeration Date 2010-11-17
Last Update Date 2010-11-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA876 ID Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 526 SHOUP AVE W
SUITE E
City TWIN FALLS
State ID
Zip Code 83301-5050

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639159056 Scott E. Allan Ophthalmology 526 Shoup Ave W, Ste H, Twin Falls, ID 83301-5050 2006-01-20
1881100097 Northwest Gastroenterology, Pllc Internal Medicine 526 Shoup Ave W, Twin Falls, ID 83301-6050 2017-12-26
1417372293 Scholes Dermatology LLC Dermatology 526 Shoup Ave W, Suite A, Twin Falls, ID 83301-6050 2014-03-03
1154561116 Joseph W Ippolito Jr Md Pllc Preferred Provider Organization 526 Shoup Ave W, Suite F, Twin Falls, ID 83301-4591 2009-03-03
1528261872 M Cole Johnson, Inc Family Medicine 526 Shoup Ave W, Suite E, Twin Falls, ID 83301-5050 2007-06-06
1306920202 Mayben Cole Johnson Family Medicine 526 Shoup Ave W, Twin Falls, ID 83301 2006-10-25
1760491542 Christopher Thad Scholes Dermatology 526 Shoup Ave W, Suite A, Twin Falls, ID 83301-6050 2006-08-07
1306862792 Joseph W Ippolito Jr. Family Medicine 526 Shoup Ave W, Suite F, Twin Falls, ID 83301-6050 2006-07-15
1598791220 Alfred C Emery Jr. Internal Medicine 526 Shoup Ave W, Suite D, Twin Falls, ID 83301-5050 2006-06-24
1477590958 Neelie Berlin Willis Physician Assistant 526 Shoup Ave W, Suite A, Twin Falls, ID 83301-5050 2006-06-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023645918 Matthew Anderson Pharmacist Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 2020-03-23
1780146316 Frontier Pediatric Partners, Pllc Pediatrics 1502 Locust Street N #700, Twin Falls, ID 83301 2019-04-02
1972073377 Wood River Acupuncture Acupuncturist 1625 Addison Ave East, Twin Falls, ID 83301 2018-11-28
1235629874 Lonnie Paul Counselor 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 2018-05-17
1679060966 Christina Jirapha Thongdee Social Worker 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 2018-04-23
1437658499 Tyrel Kevin Ward Chiropractor 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 2018-02-06
1851836381 Tanabell Health Services, Inc Skilled Nursing Facility 1134 Cheney Drive West, Twin Falls, ID 83301 2016-12-19
1578005195 Matthew Carter Physical Therapist 1053 Eastland Drive, Twin Falls, ID 83301 2016-11-14
1790227783 Murvat Usmanova Nurse Practitioner 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 2016-11-08
1265894687 Shawna Fultz Social Worker 1201 Fall Ave East Suite C, Twin Falls, ID 83301 2016-03-24
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407223274 Michael Kenneth Wucinich Physician Assistant 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 2015-08-28
1447652813 Jessea Camille Whitlow Physician Assistant 2392 Addison Ave E, Twin Falls, ID 83301-6745 2014-09-17
1174860878 Cameron Burgess Freeman Physician Assistant 325 Martin Steet, Twin Falls, ID 83301-4536 2013-01-15
1003990573 David Billings Brown Physician Assistant 943 Bitterroot Pl, Twin Falls, ID 83301-4372 2006-10-24
1447217955 Gail Rae Cook Physician Assistant 325 Martin St, Twin Falls, ID 83301-4563 2006-04-27
1902444300 Jamie Michael Engeldrum Physician Assistant 2550 Addison Ave E, Twin Falls, ID 83301-6767 2019-12-16
1023435526 Psychiatric Services Behavioral Health Clinic, Inc. Physician Assistant 493 Eastland Drive, Twin Falls, ID 83301 2014-03-21
1376876599 Jonathan B Pittard Physician Assistant 260 Falls Ave Ste C, Twin Falls, ID 83301-3370 2009-09-08
1194909598 Gladys Marie Rasch Physician Assistant 496 Shoup Ave W, Suite #e, Twin Falls, ID 83301-5043 2007-12-20
1831290097 John Urrutia Physician Assistant 176 Falls Avenue, Twin Falls, ID 83301 2006-09-26
Find all providers in TWIN FALLS

Competitor

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City TWIN FALLS
Zip Code 83301

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Dataset Information

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.

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