CHARLES M REYNOLDS (NPI# 1073770400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073770400 |
| Entity Type | Individual |
| Full Name | CHARLES M REYNOLDS |
| Credential | M.D. |
| Practice Address |
1055 N Curtis Rd Boise ID 83706-1309 |
| Mailing Address |
2100 Powell St Ste 900 Emeryville CA 94608-1844 |
| Practice Telephone | 2083672121 |
| Mailing Telephone | (510) 851-7423 |
| Mailing Fax Number | 5108799120 |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2017-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 148073 | CA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | MD2012-0479 | NM | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | MD178898 | OR | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | M-12317 | ID | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 50485 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | KAISER COMMERCIAL NUMBER | 022498 | 01 |
| CO | 22057242 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053782938 | Charles Henry Reynolds Sr. | Counselor | 504 Ne 18th Ave, Hillsboro, OR 97124-3508 | 2015-10-16 |
| 1457565533 | Charles Lee Reynolds | Specialist/Technologist | 434 E Loop 281, Ste. 103, Longview, TX 75605-7932 | 2007-05-09 |
| 1992791503 | Charles Andrew Reynolds | Pharmacist | 9934 Donna Ave, Northridge, CA 91324-1203 | 2005-09-20 |
| 1497136261 | Charles Von Reynolds | Counselor | 124 Mallard St, Greenville, SC 29601-4046 | 2015-06-17 |
| 1346679990 | Charles Edward Reynolds Jr. | Home Health | 3514 Clearbrook St, Memphis, TN 38118-5547 | 2013-11-04 |
| 1699093955 | Charles Asa Reynolds | Surgery | 1036 D A Biglane Dr, Brookhaven, MS 39601-2331 | 2010-05-12 |
| 1285804377 | Charles Norman Reynolds | Social Worker | 1020 Grosscup Ave, Dunbar, WV 25064-3128 | 2008-03-05 |
| 1982668059 | Charles A Reynolds | Family Medicine | 4515 Marsha Sharp Fwy, Lubbock, TX 79407-2520 | 2006-04-14 |
| 1609835750 | Charles F Reynolds IIi | Specialist | 3811 Ohara St, Suite 1135-e, Pittsburgh, PA 15213-2593 | 2006-03-18 |
| 1275521502 | Charles Christopher Reynolds | Physical Therapist | 690 N Cofco Center Ct, Suite 260, Phoenix, AZ 85008-6462 | 2005-10-11 |
| Street Address |
1055 N CURTIS RD |
| City | BOISE |
| State | ID |
| Zip Code | 83706-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235122284 | Christopher Jay Sjoberg | Nurse Practitioner | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2005-08-24 |
| 1689287021 | Brian Jones | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-08-25 |
| 1346868759 | Rhianna Wallace | Occupational Therapist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-12 |
| 1447877824 | Chelsea Zipse | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-01 |
| 1770105181 | Eric Munoz Quiroz | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-05-08 |
| 1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
| 1104477967 | Paul David Cochran | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-24 |
| 1649820259 | Monica Marie Mclain | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-16 |
| 1619526613 | Calan Szmyd | Genetic Counselor, MS | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-11 |
| 1922650613 | Allison A. Martinez | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| Find all providers in zip 83706 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457619074 | William P. Martin | Emergency Medicine | 1279 E Regatta St, Boise, ID 83706-6349 | 2012-05-02 |
| 1003140724 | Premium Support Services Inc | Emergency Medicine | 6568 S Federal Way, Ste 311, Boise, ID 83716-9277 | 2009-09-28 |
| 1235365545 | Boyce Kyle Fish | Emergency Medicine | 3176 S Denver Way, Boise, ID 83705-5289 | 2009-06-02 |
| 1093939464 | Edward Alan Draper | Emergency Medicine | 8599 W Victory Rd, Boise, ID 83709-4172 | 2007-04-13 |
| 1275681256 | Daniel L Meltzer | Emergency Medicine | 10583 W Lake Hazel Rd, Boise, ID 83709 | 2007-01-08 |
| 1053350744 | John Calomeni | Emergency Medicine | 211 N Flume St, Boise, ID 83712-6318 | 2006-06-06 |
| 1770538514 | Robert Hilvers | Emergency Medicine | 9976 W Emerald St, Boise, ID 83704-9769 | 2006-05-23 |
| 1184681447 | David H Kline | Emergency Medicine | 750 Warm Springs Ave Ste A, Boise, ID 83712-6457 | 2006-04-28 |
| 1457700262 | Travis Clyde | Emergency Medicine | 10583 W Lake Hazel Rd, Boise, ID 83709-6326 | 2016-06-13 |
| 1609220508 | Sarah Mcdaniels | Emergency Medicine | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2016-04-17 |
| Find all providers in BOISE | ||||
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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.