Providers
All 75 in AL
DOUGLAS SHIRLEY REYNOLDS, MD
NPI 1265537567, individual, Tuscaloosa, AL, Family Medicine
5
Evidence tier
informational
score 30 of 100, rank 11441, $225K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DOUGLAS SHIRLEY REYNOLDS, MD |
| Type | Individual |
| Status | Active |
| NPI issued | September 13, 2006, last updated November 2, 2007 |
| Practice location | 904 ANNA AVE, Tuscaloosa, AL 35401, 205-345-6960 |
| Specialties | Family Medicine (207Q00000X, primary, license 10975 AL) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $89K | 24% | $94 | $60 (top 5% from $133) | too few months to rank | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $65K | 18% | $137 | $95 (top 5% from $171) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $52K | 14% | $64 | $44 (top 5% from $110) | too few months to rank | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $45K | 12% | $27 | $32 (top 5% from $49) | 37th percentile | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $41K | 11% | $23 | $22 (top 5% from $33) | 55th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $32K | 9% | $87 | $67 (top 5% from $121) | too few months to rank | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | $15K | 4% | $17 | $20 (top 5% from $39) | too few months to rank | |
| 87807 | Detection test by immunoassay with direct visual observation for respiratory syncytial virus | $13K | 4% | $11 | $11 (top 5% from $17) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 76 | 49 | $4K | $126 | $114 | 1.1x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 13 | 12 | $522 | $96 | $81 | 1.2x | 2.2x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
75 providers in AL carry an indicator in the public record, with $75.1M at stake between them. The most common is more hours than a day holds, on 48 of them, followed by part of a provider network on 19. 6 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | DEBORAH FORD Andalusia, AL, ranked 44 | $37K |
|
| 1 | TOMMIE ROBINSON Owens Cross Roads, AL, ranked 217 | $33K |
|
| 1 | RENITA BROWN Oxford, AL, ranked 295 | $9K |
|
| 1 | CARE COMPLETE MEDICAL CLINIC(CCMC)LLC Birmingham, AL, ranked 313 | $6K |
|
| 1 | HASAN PULLIAM Anniston, AL, ranked 567 | $0 |
|
| 1 | FRANCENE GAYLE Huntsville, AL, ranked 672 | $0 |
|
| 3 | ASERACARE HOSPICE - HAMILITON, LLC Hamilton, AL, ranked 1036 | $1.1M |
|
| 3 | HOMESTEAD HOSPICE OF CAHABA, LLC Selma, AL, ranked 1404 | $60K |
|
Recent enforcement in AL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.