Jennifer Thrasher Reilly, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00330200 Issued in NJ

Practice address

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549

Phone

(609) 407-2332

NPI assigned

Mar 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Kristin Thrasher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1104242916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KNIGHTS BRIDGE WAY",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083302051",
            "telephone_number": "850-814-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345549",
            "telephone_number": "609-407-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JENNIFER",
        "middle_name": "THRASHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00330200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF MEDICAL EXAMINERS- PHYSICIAN ASSISTANT LICENSE",
            "identifier": "25MP00330200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "THRASHER",
            "middle_name": "KRISTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Jean Redmond, ACAGNP
• Maryam Rehan, M.D
• Zunaira Rehman, NP
• Douglas Reichert, PC
• Lucienne Lariane Reid-Duncan, M.D.
• Lauren Reiss
• Eileen T Renders, NUTRITIONIST N.D.
• Melissa S Resnick-Erik
• Michele L Revoir, CRNA
• Holly H Reynolds, AUD

• Surgical Physician Assistant in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.