BRADY REYNOLDS (NPI# 1275006975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275006975 |
| Entity Type | Individual |
| Full Name | BRADY REYNOLDS |
| Practice Address |
1301 Shalamar Rd Edmond OK 73013-6026 |
| Practice Telephone | 9185413300 |
| Mailing Telephone | 9185413300 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1301 SHALAMAR RD |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-6026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1679184717 | Sacy Stegall | Peer Specialist | 2902 Amanda Dr, Edmond, OK 73034-8971 | 2020-08-12 |
| 1225656309 | Preston Rody | Peer Specialist | 17861 Prairie Sky Way, Edmond, OK 73012-6628 | 2020-07-06 |
| 1730704156 | Ace Parchami | Peer Specialist | 4128 Nw 155th St, Edmond, OK 73013-9139 | 2020-06-11 |
| 1912568460 | Amber Peitzmeier | Peer Specialist | 16009 Katie Ridge Dr, Edmond, OK 73013-1498 | 2019-06-25 |
| 1326601683 | Raymond N Baker | Peer Specialist | 2309 Tuscan Ln, Edmond, OK 73034-6985 | 2019-04-22 |
| 1851859185 | Tessa Ranae Linn | Peer Specialist | 21918 Douglas Ave, Edmond, OK 73012-3218 | 2019-03-05 |
| 1063977395 | Kyle Ray Hankins | Peer Specialist | 313 E Edwards St, Edmond, OK 73034-4528 | 2019-01-31 |
| 1548731789 | Michael Lacy | Peer Specialist | 4104 Shiloh Valley Rd, Edmond, OK 73034-6912 | 2018-12-16 |
| 1073084554 | Benjamin Ortiz | Peer Specialist | 1920 E 2nd St Apt 2714, Edmond, OK 73034-6379 | 2018-12-10 |
| Find all providers in EDMOND | ||||
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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.