JOSEPH C II REYNOLDS (P.A) – Physician Assistant, NPI 1124061585
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for JOSEPH C II REYNOLDS (P.A)
Kaiser Permanente TownPark Comprehensive Medical Center, 750, Townpark Lane Northwest, Kennesaw, Cobb County, Georgia, 30144, United States
KAISER PERMANENTE TOWNPARK COMPREHENSIVE MEDICAL CENTER
KENNESAW, GA 30144
Phone: (770) 514-5401
Type: Location
7820 HICKORY FLAT HWY
WOODSTOCK, GA 301882099
Phone: (404) 504-5678
Type: Mailing
750 TOWNPARK LN NW
KAISER PERMANENTE TOWNPARK COMPREHENSIVE MEDICAL CENTER
KENNESAW, GA 301445579
Phone: (770) 514-5401
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-08-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060410000041 | I | Physician Assistant | GA | TBD |
| I20170823002639 | I | Physician Assistant | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30144)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | PA | |
| Family Practice | MN | |
| - | GA | |
| - | GA | |
| Family Practice | GA | |
| - | GA | |
| Family Practice | GA | |
| N E U R O L O G Y | GA | |
| Nurse Practitioner | GA | |
| N E U R O L O G Y | IL |
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