MR. JOEL WAYNE REYNOLDS PAC NPI 1134157233

NPI Information

NPI: 1134157233
Provider Name: MR. JOEL WAYNE REYNOLDS, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
61 CHARLES ST
DEADWOOD, SD
ZIP 57732
Phone: (605) 722-6101
Get Directions

MR. Joel Wayne Reynolds, PAC is a medical physician assistant in Deadwood, SD. MR. Joel Wayne Reynolds, PAC NPI is 1134157233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

61 CHARLES ST
DEADWOOD, SD
ZIP 57732-303
Phone: (605) 722-6101
Fax: (605) 719-6133

The NPI 1134157233 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 1/23/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	0548	SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S105124	MEDICARE PIN
2	Q08276	MEDICARE UPIN	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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