Individual provider Active NPI

John Joseph Reilly III, APRN, FNP-BC

  • Family Nurse Practitioner
  • Waipahu, HI
National Provider Identifier
1124919832
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5331 Issued in HI
Practice address
94-1101 Penakii PL
Waipahu, HI 96797-4030
Phone
(808) 330-9159
NPI assigned
Jul 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5331 HI Primary

Addresses

Primary practice location

94-1101 Penakii PL
Waipahu, HI 96797-4030

Mailing address

94-1101 Penakii PL
Waipahu, HI 96797-4030
Phone (808) 330-9159

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

State licenses

LicenseStateTypeSpecialty
5331HIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1124919832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1101 PENAKII PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974030",
            "telephone_number": "808-330-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1101 PENAKII PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974030",
            "telephone_number": "808-330-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "5331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.