Christian Charles Reilly, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001479 Issued in CT

Practice address

10 Commerce St
Suite B
Glastonbury, CT 06033-2313

Phone

(860) 430-9116

NPI assigned

Mar 16, 2007

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vivo Chiropractic Glastonbury LLC

  • Chiropractor
  • Glastonbury, CT
  • NPI 1912789231
  NPD

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174657357",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "CHRISTIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "050001479CT02",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reboot Drip Therapy LLC
• Red Lion Home Care- Connecticut
• Kaitlyn Reed
• Anika Rehman, PHARMD
• Reids Medical Supplies LLC
• Kathryn Reilly, D.C.
• William Robert Reitman, DMD
• Relieve and Revive Wellness LLC
• Renew Mental Healthcare
• Renewed Roots Therapy LLC

• Chiropractor in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Chiropractor in Connecticut

• 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.