Carly Reilly, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

10444837-4810 Issued in UT

Practice address

2 School Way
Watsonville, CA 95076-9716

Phone

(831) 818-4183

NPI assigned

Apr 17, 2019

Last updated

Mar 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1174186977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 CALABASAS RD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950760418",
            "telephone_number": "831-818-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SCHOOL WAY",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950769716",
            "telephone_number": "831-818-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "CARLY",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "10444837-4810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julia Elizabeth Reischl, NP
• Diana Renteria
• Sophia Catherine Restall
• Ana Cecilia Reyes-Ortiz, PPSC, ASW, CWA
• Wilibaldo Reyes, PA-C

• Athletic Trainer in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.