ROGER REYNOLDS (NPI# 1689682254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689682254 |
| Entity Type | Individual |
| Full Name | ROGER REYNOLDS |
| Credential | D.O. |
| Practice Address |
1825 Maple St Forest Grove OR 97116-1939 |
| Practice Telephone | 5033572136 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DO18450 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 56908 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225659709 | Roger Wayne Reynolds Sr. | Driver | 14531 Douglas Ln, Abingdon, VA 24210-4827 | 2020-05-06 |
| 1669595484 | Roger Reynolds IIi | Dentist | 3809 Forrestgate Dr Ste A, Winston Salem, NC 27103-2982 | 2007-04-08 |
| 1376687939 | Roger M Reynolds | Social Worker | 1475 Pine Grove Rd., Suite 206, Steamboat Spgs, CO 80487 | 2007-02-16 |
| 1952845760 | Roger Reynolds | Case Manager/Care Coordinator | 1017 Fayetteville Rd Se, Atlanta, GA 30316-2932 | 2016-12-13 |
| 1760478747 | Roger I. Reynolds | Pharmacist | 701 Commercial St, Atchison, KS 66002-2434 | 2005-09-23 |
| Street Address |
1825 MAPLE ST |
| City | FOREST GROVE |
| State | OR |
| Zip Code | 97116-1939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225066194 | Maple Street Clinic, PC | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-06-29 |
| 1598316846 | Ashley Amick | Physician Assistant | 1825 Maple St, Forest Grove, OR 97116-1939 | 2019-09-26 |
| 1942699897 | Hillary Md Lane | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2015-01-15 |
| 1609077528 | Joy Chiyo Dawn Gephart | Physician Assistant | 1825 Maple St, Forest Grove, OR 97116-1939 | 2007-05-29 |
| 1912064478 | Maple Street Clinic Pharmacy LLC | Pharmacy | 1825 Maple St, Forest Grove, OR 97116-1939 | 2007-01-03 |
| 1750448130 | Managed Health Care of Oregon I LLC | Pharmacy | 1825 Maple St, Forest Grove, OR 97116-1939 | 2007-01-03 |
| 1174602247 | Katrina Mcpherson | Pediatrics | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-11-02 |
| 1336157916 | Conley Lynch | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-08-03 |
| 1396753950 | Douglas Holmes | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-08-03 |
| 1003824681 | Sheridan Thiringer | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220988 | Jenny Park | Social Worker | 2023 Hawthorne Street, Building C, Forest Grove, OR 97116 | 2019-11-22 |
| 1447742077 | Kimberly K Sabin | Doula | 1239 Goff Rd, Forest Grove, OR 97116 | 2018-05-30 |
| 1891205266 | Sonam Narayan | Optometrist | 2221 Pacific Avenue, Forest Grove, OR 97116 | 2017-10-11 |
| 1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
| 1336445535 | Shane Michael Peterson | Physical Therapist | 3300 19th Avenue, Forest Grove, OR 97116 | 2011-02-04 |
| 1023324415 | Kara Marie Cooper | Registered Nurse | 2221 Oak St, Forest Grove, OR 97116 | 2010-08-24 |
| 1811229792 | Rachel Lucinda Erin Dilly | Speech-Language Pathologist | 3300 19th Ave., Forest Grove, OR 97116 | 2010-02-03 |
| 1720286339 | Thuymai Anna Fee | Physical Therapist | Custom Care Physical Therapy, 4150 Pacific Ave. #100, Forest Grove, OR 97116 | 2007-07-05 |
| 1629102454 | Lois Elizabeth Yevdalcia Dimick | Massage Therapist | 2004 Main St, Suite 204, Forest Grove, OR 97116 | 2007-03-15 |
| 1023159936 | Ninette Kay Foster | Contractor | 2329 Pacific Ave., Forest Grove, OR 97116 | 2007-02-12 |
| Find all providers in zip 97116 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750433058 | William Alsop Bours Iv | Family Medicine | 3303 19th Ave, Forest Grove, OR 97116-1909 | 2007-01-17 |
| 1225057011 | Marilyn J Booth | Family Medicine | 3305 19th Ave, Forest Grove, OR 97116-1909 | 2006-07-19 |
| 1225066194 | Maple Street Clinic, PC | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-06-29 |
| 1003810441 | Timothy J. Gray Sr. | Family Medicine | 1909 Mountain View Ln, Suite 200, Forest Grove, OR 97116-2893 | 2005-06-13 |
| 1629421805 | Pacific University | Family Medicine | 2043 College Way, Forest Grove, OR 97116-1756 | 2016-07-22 |
| 1942699897 | Hillary Md Lane | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2015-01-15 |
| 1841418704 | Karen Louise Kustritz | Family Medicine | 3305 19th Ave, Forest Grove, OR 97116-1909 | 2007-04-23 |
| 1366570798 | Bours Health Center | Family Medicine | 3303 19th Ave, Forest Grove, OR 97116-1909 | 2007-02-28 |
| 1265586317 | Marilyn J Booth Md | Family Medicine | 3305 19th Ave, Forest Grove, OR 97116-1909 | 2007-01-23 |
| 1336157916 | Conley Lynch | Family Medicine | 1825 Maple St, Forest Grove, OR 97116-1939 | 2006-08-03 |
| Find all providers in FOREST GROVE | ||||
| City | FOREST GROVE |
| Zip Code | 97116 |
Please comment or provide details below to improve the information on ROGER REYNOLDS.
| 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.