JENNA MARIE REYNOLDS (AU.D., CCC-A) – Audiologist, NPI 1417846809

JENNA MARIE REYNOLDS (AU.D., CCC-A) is a healthcare provider. based in Okemos, Michigan. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AU.D., CCC-A. They hold a License No. 1601001218 (MI). The NPI Number for JENNA MARIE REYNOLDS (AU.D., CCC-A) is 1417846809

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
JENNA MARIE REYNOLDS (AU.D., CCC-A)
NPI
1417846809
Phone
(218) 590-8344
Address
3637 JOLLY OAK RD UNIT B2094
Enumeration Date
30 June 2025
Last Update Date
30 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5173244911
Graduation Year
2025 (1 year ago)
PAC ID
6406363860
Group Practice PAC ID
1052363801
Professional Enrollment ID
I20250730000456
Address ID
MI488231956EA1500XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

302 QUALIFIED AUDIOLOGIST in MI

Provider Addresses for JENNA MARIE REYNOLDS (AU.D., CCC-A)

  • 3637 JOLLY OAK RD UNIT B2094

    OKEMOS, MI 488642520

    Phone: (218) 590-8344

    Type: Mailing

  • 1500 ABBOT RD STE 400

    EAST LANSING, MI 488231956

    Phone: (517) 332-0100

    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: 2025-07-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250730000456IQualified AudiologistMITBD

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.

Verify on CMS Revalidation Lookup Tool

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 48864)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052363801View full group profile
NameSpecialtyState
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
O T O L A R Y N G O L O G YMI
-MI
O T O L A R Y N G O L O G YMI
Qualified AudiologistMI
Occupational Therapist In Private PracticeMI
Qualified AudiologistMI
Qualified AudiologistMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for JENNA MARIE REYNOLDS (AU.D., CCC-A)?
JENNA MARIE REYNOLDS (AU.D., CCC-A) — NPI 1417846809 — is the standard way to identify this listing.
Does the file indicate JENNA MARIE REYNOLDS (AU.D., CCC-A) is practicing under active NPI?
Directory data currently reports JENNA MARIE REYNOLDS (AU.D., CCC-A) as active.
What taxonomy line describes JENNA MARIE REYNOLDS (AU.D., CCC-A)?
For research purposes, treat JENNA MARIE REYNOLDS (AU.D., CCC-A) as Audiologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is JENNA MARIE REYNOLDS (AU.D., CCC-A) based?
JENNA MARIE REYNOLDS (AU.D., CCC-A) is tied to Okemos, Michigan in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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