DR. JACOB REYNOLDS (NPI# 1205380342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205380342 |
| Entity Type | Individual |
| Full Name | DR. JACOB REYNOLDS |
| Credential | PT, DPT |
| Practice Address |
1695 Marietta Blvd Nw Atlanta GA 30318-3644 |
| Mailing Address |
1695 Marietta Boulevard Nw Atlanta GA 30318 |
| Practice Telephone | 4043828702 |
| Mailing Telephone | 4043828702 |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
PT012532 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT012532 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710435433 | Jacob Reynolds | Technician, Other | 6170 Central St, Romulus, MI 48174-4217 | 2016-09-12 |
| 1336781830 | Jacob Nicholas Reynolds | Physical Therapist | 1311 Wakarusa Dr Ste 1000, Lawrence, KS 66049-1741 | 2019-10-16 |
| 1437507456 | Jacob Reynolds | Ophthalmology | 3601 4th St, Lubbock, TX 79430-0002 | 2016-05-31 |
| 1528412210 | Jacob Reynolds | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2016-04-19 |
| Street Address |
1695 MARIETTA BLVD NW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30318-3644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669862769 | Westside Physical Therapy, LLC | Physical Therapist | 1695 Marietta Blvd Nw, At Atlanta Ballet, Atlanta, GA 30318-3644 | 2015-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659970408 | Laura N Gillespie | Physician Assistant | 1800 Howell Mill Rd., Suite 450, Atlanta, GA 30318 | 2020-10-22 |
| 1639793664 | 100 Percent Chiropractic Sberger LLC | Chiropractor | 2250 Marietta Blvd, Suite 303, Atlanta, GA 30318 | 2020-06-05 |
| 1326518945 | Sharon Emancia Joseph | Nurse Practitioner | 1517 Whitehead Bluff Nw, Atlanta, GA 30318 | 2018-11-27 |
| 1124597646 | Cindy Denise Oden | Registered Nurse | 1903 Drew Dr Nw, Apt 2200, Atlanta, GA 30318 | 2018-11-14 |
| 1558838052 | Amanda Renee Wilson | Social Worker | 2118 Adams Overlook Nw, Atlanta, GA 30318 | 2018-11-01 |
| 1386135010 | Missions Possible of Atlanta Day Program LLC. | Counselor | 805 Ayrshire Cir Nw, Atlanta, GA 30318 | 2018-05-29 |
| 1295254639 | Danielle Olivia Jones | Counselor | 1391 Collier Road Nw, Apt 1304, Atlanta, GA 30318 | 2017-09-18 |
| 1104372317 | Kera Baker | Massage Therapist | 1397 B Carroll Drive Nw, Atlanta, GA 30318 | 2016-08-28 |
| 1588015648 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 1000 Techwood Dr Nw, Atlanta, GA 30318 | 2016-06-29 |
| 1104286707 | B Webb, Inc | Specialist | 1675 Lower Roswell Rd, Marietta, GA 30318 | 2016-02-25 |
| Find all providers in zip 30318 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649791005 | Caitlin Moriah Clark | Physical Therapist | 1995 N Park Pl Se Ste 410, Atlanta, GA 30339-2072 | 2017-07-06 |
| 1669862769 | Westside Physical Therapy, LLC | Physical Therapist | 1695 Marietta Blvd Nw, At Atlanta Ballet, Atlanta, GA 30318-3644 | 2015-01-27 |
| 1689073553 | Ilana Danneman | Physical Therapist | 2016 Lakesprings Way, Atlanta, GA 30338-4414 | 2014-08-17 |
| 1366851107 | Mackenzie Olson | Physical Therapist | 1365 Clifton Rd Ne Ste 2218, Atlanta, GA 30322-1013 | 2014-08-06 |
| 1992066013 | Nia I Seidu-clark | Physical Therapist | 688 Spring St, Atlanta, GA 30354-1414 | 2012-06-05 |
| 1750601464 | Audrey K Jones | Physical Therapist | 195 Arizona Ave., L/w-2, Suite 400, Atlanta, GA 30307 | 2010-06-03 |
| 1588995054 | Stacy Hosp | Physical Therapist | 3280 Peachtree Rd Ne, 225, Atlanta, GA 30305-2430 | 2010-01-24 |
| 1326372293 | Leslie K Wolfe | Physical Therapist | 1144 Zimmer Dr Ne, Atlanta, GA 30306-3321 | 2009-09-25 |
| 1912988098 | Injury Prevention & Management Consulting LLC | Physical Therapist | 1 Dunwoody Park, Suite 121, Atlanta, GA 30338-6202 | 2005-11-07 |
| 1982266284 | Sabrina Michelle Viola | Physical Therapist | 3200 Downwood Cir Nw Ste 700, Atlanta, GA 30327-5308 | 2019-07-08 |
| Find all providers in ATLANTA | ||||
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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.