Active NPI
Sean Michael Reilly, RNC,NNP
- Critical Care Neonatal Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1386950418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Neonatal Nurse Practitioner
- License
- 5009794
- Practice address
- 4420 Lake Boone TRL
Raleigh, NC 27607-7505 - Phone
- (919) 784-3100
- NPI assigned
- Aug 26, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | COA07506NP | OH | |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 5009794 | NC | Primary |
Addresses
Primary practice location
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Mailing address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3100
Other practice location 1
2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4095
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sreilly31879@direct.unc.nchie.net | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5009794 | NC | MD | Critical Care Neonatal Nurse Practitioner |
| COA07506NP | OH | MD | Critical Care Neonatal Nurse Practitioner |
Interoperability endpoints
- sreilly318719@direct.unc.nchie.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1386950418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077505",
"telephone_number": "919-784-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 LAKE BOONE TRL",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077505",
"telephone_number": "919-784-3100"
}
],
"practiceLocations": [
{
"address_1": "2951 Maple Ave",
"address_purpose": "LOCATION",
"city": "Zanesville",
"state": "OH",
"postal_code": "437011406",
"country_code": "US",
"telephone_number": "740-454-4095",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REILLY",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"credential": "RNC,NNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-26",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "OH",
"license": "COA07506NP",
"primary": false
},
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "NC",
"license": "5009794",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sreilly31879@direct.unc.nchie.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "4420 Lake Boone Trl",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276077505",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.