Provider Demographics
NPI:1609037399
Name:REYNOLDS, CASSANDRA LANE (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:LANE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:DR
Other - First Name:CASSANDRA
Other - Middle Name:LANE
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 E HAMPDEN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-788-5300
Mailing Address - Fax:
Practice Address - Street 1:601 E HAMPDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:303-788-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5610208600000X
CODR-0058564208600000X, 2086S0127X, 2086S0102X
NC2014-00568208600000X, 2086S0102X, 2086S0127X
CAA1239752086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18522OtherBCBS NC
NC1609037399Medicaid
NCNCH963AMedicare PIN