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DR. TYLER SHANE REYNOLDS MD NPI 1376737874


NPI Information

NPI: 1376737874
Provider Name: DR. TYLER SHANE REYNOLDS, MD
Classification: Surgery - 2086S0102X
Entity Type: Individual

Specialization: Surgical Critical Care

PECOS Registration: Yes

Address:
3800 S NATIONAL AVE STE 600
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 875-3000
Get Directions

DR. Tyler Shane Reynolds, MD is a surgical critical care surgery in Springfield, MO with 18 years of experience. The provider is a surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. DR. Tyler Shane Reynolds, MD NPI is 1376737874. 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:

3800 S NATIONAL AVE STE 600
SPRINGFIELD, MO
ZIP 65807-249
Phone: (417) 875-3000

The NPI 1376737874 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 8/28/2007 and was last updated on 8/10/2023.


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
1208600000XSurgery2022007281MISSOURINo
2208600000XSurgery074569GEORGIANo
32086S0102XSurgerySurgical Critical CareME163370FLORIDAYes
4208600000XSurgeryA101986CALIFORNIANo

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
1200116135MEDICAIDMISSOURI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.