DEREK J REYNOLDS (NPI# 1285074054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285074054 |
Entity Type | Individual |
Full Name | DEREK J REYNOLDS |
Credential | FNP |
Practice Address |
183 Park St Suite 7 Malone NY 12953-1238 |
Mailing Address |
908 Niagara Falls Blvd Suite 208 North Tonawanda NY 14120-2019 |
Practice Telephone | 5184812801 |
Practice Fax Number | 5184812486 |
Mailing Telephone | 7166923302 |
Mailing Fax Number | 7163323525 |
Enumeration Date | 2013-06-26 |
Last Update Date | 2013-06-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F338090-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154893220 | Derek J Reynolds | Pharmacist | 572 32 Rd, Clifton, CO 81520-7606 | 2018-12-29 |
Street Address |
183 PARK ST SUITE 7 |
City | MALONE |
State | NY |
Zip Code | 12953-1238 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134107600 | Myrna A Sanchez-latreille | Internal Medicine | 183 Park St, Suite 5, Malone, NY 12953-1238 | 2006-01-05 |
1780235622 | Jennifer Lynn Shull | Nurse Practitioner | 183 Park St, Malone, NY 12953-1242 | 2019-09-23 |
1578123139 | Tammy Marie Coffey | Physician Assistant | 183 Park St, Malone, NY 12953-1242 | 2019-06-17 |
1558659367 | Dragos Banu | Internal Medicine | 183 Park St, Malone, NY 12953-1238 | 2011-07-13 |
1639465941 | Erika A Thompson | Physician Assistant | 183 Park St, Suite 5 & 6, Malone, NY 12953-1238 | 2011-06-24 |
1528357274 | Pierre Dominique Mechali | Urology | 183 Park St, Suite 3, Malone, NY 12953-1238 | 2011-04-04 |
1265671663 | Sonia R Jospeh D.o. Pllc | Obstetrics & Gynecology | 183 Park St, Suite 1, Malone, NY 12953-1238 | 2009-02-10 |
1780623439 | Margaret Lowell | Nurse Practitioner | 183 Park St, Suite 5, Malone, NY 12953-1238 | 2006-06-06 |
1033165956 | Myrna Sanchez | Specialist | 183 Park St, Suite 5, Malone, NY 12953-1238 | 2006-05-25 |
1275594665 | Emile Benardot | Pediatrics | 183 Park St, Suite 2, Malone, NY 12953-1238 | 2006-03-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386264356 | Ruth Ann Williamson | Nurse Practitioner | 31 Sixth St., Malone, NY 12953 | 2020-04-20 |
1780203760 | Heather Lynn Lauzon | Peer Specialist | 15 Fouth St, Malone, NY 12953 | 2020-04-10 |
1245717115 | Darlean James | Family Medicine | 183 Park St Ste 5678, Malone, NY 12953 | 2018-07-24 |
1164929212 | Cheryl Ann Grant | Registered Nurse | 15 Fourth Street, Malone, NY 12953 | 2018-04-06 |
1811408826 | Nancy Denis | Registered Nurse | 133 Park Street, Alice Hyde Medical Center, Malone, NY 12953 | 2017-10-17 |
1003325424 | Tara Lynn Ellis | Registered Nurse | 23 Husky Lane, Malone, NY 12953 | 2017-09-28 |
1578092185 | Shanna Lee Cayea | Peer Specialist | 31 6th Street, Malone, NY 12953 | 2017-06-07 |
1184007809 | Alice Hyde Medical Center | Home Health | 45 Sixth St, Malone, NY 12953 | 2015-06-30 |
1427303353 | Melissa J Benardot | Nurse Practitioner | 380 Cty Rt 57, Community Health Center, Malone, NY 12953 | 2012-07-17 |
1013272202 | Shafiu Oladele Ololade | Internal Medicine | 10 Third Street, Malone, NY 12953 | 2012-07-12 |
Find all providers in zip 12953 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336179365 | Stephanie Leffler | Nurse Practitioner | 183 Park Street, Suite 5, Malone, NY 12953 | 2006-07-04 |
1811537608 | Qi Si Xue | Nurse Practitioner | 133 Park St, Malone, NY 12953-1244 | 2020-01-09 |
1487170882 | Stacy Ann Mckenzie- Harvey | Nurse Practitioner | 45 6th St, Malone, NY 12953-1247 | 2017-08-17 |
1699127795 | Brianne Jeror | Nurse Practitioner | 133 Park St, Malone, NY 12953-1244 | 2016-07-13 |
1598148967 | Joshua A Craig | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2015-07-03 |
1194107789 | Jessica Marie Robinson | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2015-06-19 |
1790799898 | Brenda Lepage | Nurse Practitioner | 133 Park St, Malone, NY 12953-1220 | 2006-07-27 |
1528091436 | Mary Reilly Mcgonagle | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2006-07-07 |
1407815699 | Barbara Jo Sherwin | Nurse Practitioner | 155 Finney Blvd, Cp of The North Country, Malone, NY 12953 | 2006-03-17 |
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1871194027 | Wai Ying Chan | Nurse Practitioner | 659 Britton Ave, Staten Island, NY 10304-4463 | 2020-11-04 |
1063013258 | Iris Massiel Garcia | Nurse Practitioner | 2206 Dr Martin L King Jr Blvd, Bronx, NY 10453-1307 | 2020-11-04 |
1104427525 | Jeanine R Williams | Nurse Practitioner | 4213 Foster Ave, Brooklyn, NY 11203-5711 | 2020-11-03 |
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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.