Shannon Marie Reilly

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

F311012-01 Issued in NY

Practice address

4 W 58TH St
New York, NY 10019-2515

Phone

(845) 826-4073

NPI assigned

Mar 24, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1144923327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 LEONARD ST APT 409",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133494",
            "telephone_number": "845-826-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W 58TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192515",
            "telephone_number": "845-826-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F311012-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael William Reilly, LMSW
• Mireya Reilly, N.P.
• Muredach P Reilly, MD
• Nicolette Ann Reilly, PA-C
• Norelle Rizkalla Reilly, M.D.
• William Peter Reilly II, PT
• Jennifer Louise Reim, M.S., PA-C
• Marta Reiman, LMT
• Stacey Reimann
• Allysa Reimer, FNP

• Gerontology Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Gerontology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.