DR. JACKSON DAVID REYNOLDS MD
NPI 1598345647
General Practice in Phoenix, AZ

Q: What is Jackson Reynolds's NPI number?

The NPI number for Jackson Reynolds is 1598345647. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Q: What is Jackson Reynolds's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Jackson Reynolds was last updated on March 18, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 13, 2021PECOS Enrolled

1300 N 12TH ST STE 508, PHOENIX, AZ 85006(602) 839-3927(602) 839-4233 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Jackson David Reynolds Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACKSON DAVID REYNOLDS MD (NPI 1598345647) is an individual general practice provider in Phoenix, Arizona, licensed in Arizona (72531) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1598345647

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. JACKSON DAVID REYNOLDSCredential: MD

Location Address1300 N 12TH ST STE 508Phoenix, AZ 85006-2849

Mailing Address1111 E Mcdowell RdPhoenix, AZ 85006-2612

Phone(602) 839-3927

Fax(602) 839-4233

Sole ProprietorNo

Enumeration DateApril 13, 2021

Last NPPES UpdateMarch 18, 2024

NPPES CertifiedMarch 18, 2024

✔ NPI 1598345647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in AZ · 72531

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedInternal MedicineTaxonomy 207R00000X · License 72531 (AZ)

Also ListedPediatricsTaxonomy 208000000X · License 72531 (AZ)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1300 N 12TH ST STE 508, Phoenix, AZ 85006

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jackson David Reynolds Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TREVIN REYES MD

Student in an Organized Health Care Education/Training Program