MR. SAMUEL D. MCREYNOLDS


Address: 537 Union Ave, Grants Pass, OR 97527-5543
Phone: 5414796777

MR. SAMUEL D. MCREYNOLDS (NPI# 1902832652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902832652
Entity Type Individual
Full Name MR. SAMUEL D. MCREYNOLDS
Credential PA-C
Practice Address 537 Union Ave
Grants Pass
OR 97527-5543
Mailing Address 2825 E Barnett Rd
Medford
OR 97504-8332
Practice Telephone 5414796777
Practice Fax Number 5414796779
Mailing Telephone 5417894281
Enumeration Date 2006-06-24
Last Update Date 2020-02-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA60914100 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AZ 881062 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
7846 E Vista Bonita Dr, Scottsdale, AZ 852554123 4808601045 4806648889

Office Location

Street Address 537 UNION AVE
City GRANTS PASS
State OR
Zip Code 97527-5543

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255976197 Alisha Naomi Zauher Nurse Practitioner 537 Union Ave, Grants Pass, OR 97527 2019-11-14
1023575891 Kristen Clark Specialist/Technologist 537 Union Ave, Grants Pass, OR 97527-5543 2019-02-27
1225516537 Jessie Kristen Hermant Nurse Practitioner 537 Union Ave, Grants Pass, OR 97527-5543 2018-07-30
1760973739 Taira Coryn Butler Registered Nurse 537 Union Ave, Grants Pass, OR 97527 2018-05-24
1073041158 Courtney Marie Wedgeworth Otolaryngology 537 Union Ave, Grants Pass, OR 97527-5543 2017-06-01
1073063772 Beau J Shelton Physician Assistant 537 Union Ave, Grants Pass, OR 97527-5543 2016-10-06
1578918546 Gabrielle Marie Fey Registered Nurse 537 Union Ave, Grants Pass, OR 97527-5543 2016-04-27
1093169104 App Ent Otolaryngology 537 Union Ave, Second Floor -2c, Grants Pass, OR 97527-5543 2016-04-15
1811341928 App Orthopedic Clinic Orthopaedic Surgery 537 Union Ave, Second Floor 2a, Grants Pass, OR 97527-5543 2016-04-15
1124472246 App Urology Clinic Urology 537 Union Ave, Second Floor 2b, Grants Pass, OR 97527-5543 2016-04-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528618600 Sandra J Campos Technician 365 Sleepy Hollow Loop, Grants Pass, OR 97527 2019-09-19
1720501026 Kelly Bates Massage Therapist 501 Cheney Creek Rd, Grants Pass, OR 97527 2017-07-19
1740650134 Sara Brelsford Nurse Practitioner 1075 Sw Grandview Avenue, Suite 200, Grants Pass, OR 97527 2015-09-29
1962816348 Kimberly Hathaway Counselor 320 Ramsey Place, Grants Pass, OR 97527 2014-06-13
1801216999 Christina Ann Marie Schultz Massage Therapist 242 Curtis Drive, Grants Pass, OR 97527 2014-04-16
1013343359 Shaunte Angelique Duron Counselor 711 Sw Ramsey Avenue, Grants Pass, OR 97527 2013-09-18
1063848547 Megan Faye Armstrong Behavioral Analyst 715 Ramsey Aveenue, Grants Pass, OR 97527 2013-09-17
1124454608 Mark Albert Cook Behavioral Analyst 1153 Sw Cal Allen Lane, Grants Pass, OR 97527 2013-09-17
1952741969 Mitchell K Sheeler Denturist 1850 Williams Hwy, Grants Pass, OR 97527 2013-07-05
1790038339 White City Vamc Clinic/Center 1877 Williams Highway, Grants Pass, OR 97527 2012-10-19
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982603395 Carey Janzik Physician Assistant 625 Ramsey Ave, Grants Pass, OR 97527-5808 2005-07-18
1598136368 David Woodbury Physician Assistant 537 Union Ave, Grants Pass, OR 97527-5543 2015-10-19
1235541376 Richard Ombrembowski Physician Assistant 537 Union Ave, Grants Pass, OR 97527-5543 2014-05-23
1720408321 Jessica Francom Physician Assistant 625 Sw Ramsey Ave, Suite A, Grants Pass, OR 97527-5808 2014-04-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1619575008 Janna Marie Check Physician Assistant 3555 Chad Drive, Eugene, OR 97408 2020-10-16
1922588508 Melanie Grace Mix Physician Assistant 501 N Graham St Ste 420, Portland, OR 97227 2018-08-14
1396250122 Saron Theresa Sufuentes Physician Assistant 578 Nw Marlborough Ave, Portland, OR 97210-3104 2017-12-01
1801321039 Devin Fleming Physician Assistant 22936 Ne Pike St, Troutdale, OR 97060-2615 2017-04-25
1710435011 Alexander Andersen Physician Assistant 445 Harlow Rd Ste 200, Springfield, OR 97477-1341 2016-09-14
1952775520 Lauren Govier Physician Assistant 501 N Graham St Ste 415, Portland, OR 97227-2006 2015-11-19
1619346368 Ryan Mcmahon Physician Assistant 3415 Ne 20th Ave, Portland, OR 97212-2416 2015-09-23
1518366863 Latoya Allen Physician Assistant 2450 Highgate St, Unit 12, Medford, OR 97501-7955 2014-08-21
1528499910 Elan Kennedy Physician Assistant 3181 Sw Sam Jackson Park Rd., Mail Code L353, Ohsu, Division of Cardiothoracic Surgery, Portland, OR 97239 2013-12-10
1699114421 Lauren M Kendall Physician Assistant 960 N 16th St Ste 108, Springfield, OR 97477-4175 2013-06-14
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Competitor

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City GRANTS PASS
Zip Code 97527

Improve Information

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Dataset Information

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.

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