DR. MICHAEL D REYNOLDS (NPI# 1689686065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689686065 |
Entity Type | Individual |
Full Name | DR. MICHAEL D REYNOLDS |
Credential | MD |
Practice Address |
12266 Depaul Dr. Suite 305 Bridgeton MO 63044-2516 |
Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
Practice Telephone | 3147700991 |
Practice Fax Number | 3147700692 |
Enumeration Date | 2006-08-13 |
Last Update Date | 2020-10-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208600000X | Surgery | R1J28 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 202545612 | 05 | |
MO | RAILROAD MEDICARE | 770001238 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164035655 | Michael Justin Reynolds | Home Health Aide | 3926 Southern Ave Se, 101, Washington, DC 20020-2002 | 2020-08-25 |
1578105243 | Michael L Reynolds | Dentist | 7742 Herschel Ave Ste I, La Jolla, CA 92037-4444 | 2019-10-14 |
1568769743 | Michael David Reynolds | Rehabilitation Practitioner | 6486 Violet Breeze Way, Las Vegas, NV 89142-0997 | 2011-02-23 |
1881913150 | Michael Henry Reynolds II | Social Worker | 32790 State Highway 99 S, Stonewall, OK 74871-6128 | 2010-05-25 |
1164740767 | Michael W Reynolds | Social Worker | 108 Lincoln Rd Nw, Lake Placid, FL 33852-9728 | 2010-05-07 |
1942534714 | Michael P Reynolds | Occupational Therapy Assistant | 2457 N 81st St, Wauwatosa, WI 53213-1012 | 2009-09-28 |
1861654626 | Michael Thomas Reynolds | Dentist | 625 E. Nicollet Blvd, Suite 340, Burnsville, MN 55337 | 2008-07-01 |
1457319543 | Michael J Reynolds | Anesthesiology | 4821 Montgomery Ln, 801, Bethesda, MD 20814-3471 | 2006-05-01 |
1669436770 | Michael Bryan Reynolds | Family Medicine | 3480 Deltona Blvd, Spring Hill, FL 34606-2917 | 2006-04-14 |
1265418560 | Michael Connell Reynolds | Counselor | 251 Country Club Dr, Eden, NC 27288-3554 | 2005-12-19 |
Street Address |
12266 DEPAUL DR. SUITE 305 |
City | BRIDGETON |
State | MO |
Zip Code | 63044-2516 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629012042 | Thomas B. Charles | Surgery | 12266 Depaul Dr., Suite 305, Bridgeton, MO 63044-2516 | 2006-06-15 |
1336456466 | William Frederick Kelly | Physical Therapist | 12266 Depaul Dr., Suite 115, Bridgeton, MO 63044 | 2010-09-10 |
1437254869 | Vascular Institute At Depaul | Radiology | 12266 Depaul Dr., Suite 315, Bridgeton, MO 63044 | 2006-09-13 |
1336252204 | Tauqir X Ahmed | Surgery | 12266 Depaul Dr., Suite 305, Bridgeton, MO 63044-2516 | 2006-08-16 |
1710999115 | Surgical Arts of St Louis,ltd | Surgery | 12266 Depaul Dr., Suite 305, Bridgeton, MO 63044-2516 | 2006-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
Find all providers in zip 63044 |
Taxonomy Code | 208600000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629012042 | Thomas B. Charles | Surgery | 12266 Depaul Dr., Suite 305, Bridgeton, MO 63044-2516 | 2006-06-15 |
1770537326 | Imran Ul Haq | Surgery | 10 Magnolia Avenue, Suite E, Bridgeton, NJ 08302 | 2006-05-19 |
1932150638 | Richard H. Roettger | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044 | 2006-05-15 |
1619953064 | Darrell Martin Pitt | Surgery | 3444 Mckelvey Rd, Bridgeton, MO 63044-2525 | 2005-12-19 |
1912905134 | Marco A Castaneda | Surgery | 12255 Depaul Drive, #675n, Bridgeton, MO 63044 | 2005-07-12 |
1881079994 | Arch Bariatrics LLC | Surgery | 3394 Mckelvey Rd, Suite 115, Bridgeton, MO 63044-2531 | 2015-07-30 |
1164804035 | Kyle Christensen | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2015-06-26 |
1619231636 | Betsy L Krebs | Surgery | 12266 De Paul Dr Ste 305, Bridgeton, MO 63044-2514 | 2012-06-25 |
1427375450 | Andrea Maria Zelisko Schwoerer | Surgery | 12266 Depaul Drive, Suite 210, Bridgeton, MO 63044 | 2010-04-30 |
1518137603 | Sae R. Choi | Surgery | 12121 Saint Charles Rock Rd, Bridgeton, MO 63044-2602 | 2008-03-05 |
Find all providers in BRIDGETON |
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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.