Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ricco Cory Reynolds, FNP-C

Individual provider Athletic Trainer · NPI 1205435997

Mr. Ricco Cory Reynolds, FNP-C is a Nurse Practitioner in Portland, Oregon. Qualified in 2022, 4 years ago. Practices with University Professional Services, a 1,704-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Washington.

Years since qualifying
4
Licensed in
OR, WA
In the registry since
2020
Specialties on file
4
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-8311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 202213334NP-PP (OR)
Athletic Trainer Taxonomy 2255A2300X
Family Nurse Practitioner Taxonomy 363LF0000X · Licence API61363661 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1205435997
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedOctober 22, 2020
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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