Active NPI
Peter Anthony Reilly, PHARMD
- Psychiatric Pharmacist
- Detroit, MI
National Provider Identifier
1003927658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 5302019994
- Practice address
- 4646 John R St
Pharmacy Section
Detroit, MI 48201-1916 - Phone
- (313) 576-4635
- Fax
- (313) 576-1194
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 5302019994 | MI | Primary |
Addresses
Primary practice location
4646 John R St
Pharmacy Section
Detroit, MI 48201-1916
Mailing address
2870 Pebble Creek Dr
Ann Arbor, MI 48108-1728
Phone (734) 971-6863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302019994 | MI | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003927658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2870 PEBBLE CREEK DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081728",
"telephone_number": "734-971-6863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"address_2": "PHARMACY SECTION",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-4635",
"fax_number": "313-576-1194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "PETER",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "MI",
"license": "5302019994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.