Individual provider Active NPI

Kara Reilly, LSW, LICDC, RN, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • North Olmsted, OH
National Provider Identifier
1235657420
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.022864 Issued in OH
Practice address
4466 Ranchview Ave
North Olmsted, OH 44070-2744
Phone
(419) 376-2179
NPI assigned
Sep 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.434430 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.022864 OH Primary

Addresses

Primary practice location

4466 Ranchview Ave
North Olmsted, OH 44070-2744

Mailing address

4466 Ranchview Ave
North Olmsted, OH 44070-2744
Phone (419) 376-2179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180827002239 OH Practitioner - Nurse Practitioner 7416206313 Reassigns benefits to 2 organizations
I20210304002524 NY Practitioner - Nurse Practitioner 7416206313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.434430OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince Nov 1, 2018 Accepting new patients
Family Service League, Inc. CurrentSince Feb 4, 2021 Accepting new patients
Wings of Nature Mental Health Care LLC CurrentSince Apr 21, 2024 Accepting new patients
Access Ohio, LLC CurrentSince Jul 17, 2018 Accepting new patients
Access Ohio, LLC CurrentSince Jul 17, 2018 Accepting new patients
Haely Chiropractic, Inc. PastSince Oct 1, 2001 Accepting new patients

Locations

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

7555 Main Rd
Mattituck, NY 11952
Phone (631) 298-1678

4725 Parkwick Dr
Ste 100
Columbus, OH 43228
Phone (614) 655-3354

6400 E Broad St
Ste 400
Columbus, OH 43213
Phone (614) 367-7700

6400 E Broad St
Columbus, OH 43213
Phone (614) 367-7700

8100 Ravines Edge Ct
Ste 200
Columbus, OH 43235
Phone (614) 655-3345

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

Interoperability endpoints

  • Direct secure messaging: comprehensiveminds.karareilly@147239.advancedmd-direct.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1235657420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 RANCHVIEW AVE",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440702744",
            "telephone_number": "419-376-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 RANCHVIEW AVE",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440702744",
            "telephone_number": "419-376-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "KARA",
        "credential": "LSW, LICDC, RN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.434430",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.022864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Olmsted, OH

Sources for this page

Verify at the official NPI Registry.