{"npi":"1043603764","type":"NPI-1","status":"active","name":{"display":"Mitchell Reynolds CRNA","other":[],"first":"MITCHELL","last":"REYNOLDS","credential":"CRNA"},"specialty":{"primary_taxonomy":"367500000X","primary_taxonomy_description":"Certified Registered Nurse Anesthetist","slug":"certified-registered-nurse-anesthetist","schema_org_specialty":null,"all":[{"code":"163W00000X","description":"Registered Nurse","primary":false,"state":"MI","license":"47404282268"},{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":false,"state":"IL","license":"209023353"},{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":false,"state":"FL","license":"APRN11020059"},{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":true,"state":"MI","license":"4704282268"}]},"addresses":[{"purpose":"LOCATION","street_1":"4100 PARK FOREST DR","city":"TRAVERSE CITY","state":"MI","postal_code":"496847331","country_code":"US","street_2":"SUITE 210","phone":"2319355770","fax":"2319350747"},{"purpose":"MAILING","street_1":"4100 PARK FOREST DR","city":"TRAVERSE CITY","state":"MI","postal_code":"496847331","country_code":"US","street_2":"SUITE 210","phone":"2319355770","fax":"2319350747"}],"license":{"state":"MI","number":"4704282268"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20220819000615","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"FL","pac_id":"7012220627"}]},"enumeration_date":"2015-03-05","last_updated":"2025-01-06","_meta":{"source":"NPPES","snapshot_date":"2025-01-06","doc_url":"https://findmynpi.com/api"}}