Individual provider Active NPI

Kathryn Reilly, D.C.

  • Chiropractor
  • Glastonbury, CT
National Provider Identifier
1073636643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1603 Issued in CT
Practice address
10 Commerce St
Suite B
Glastonbury, CT 06033-2313
Phone
(860) 430-9116
Fax
(860) 430-9108
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1603 CT Primary

Addresses

Primary practice location

10 Commerce St
Suite B
Glastonbury, CT 06033-2313

Mailing address

10 Commerce St
Suite B
Glastonbury, CT 06033-2313
Phone (860) 430-9116

Other identifiers 1

IdentifierTypeStateIssuer
1603OtherCTLICENSE

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Vivo Chiropractic Glastonbury LLC Chiropractor PastSince Oct 22, 2023 Accepting new patients
Chiromark, LLC Chiropractor PastSince Dec 7, 2009 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073636643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COMMERCE ST",
            "address_2": "SUITE B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332313",
            "telephone_number": "860-430-9116",
            "fax_number": "860-430-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 COMMERCE ST",
            "address_2": "SUITE B",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332313",
            "telephone_number": "860-430-9116",
            "fax_number": "860-430-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1603",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

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.

Verify at the official NPI Registry.