Active NPI
Robert James Reilly, PA-C
- Physician Assistant
- Ord, NE
National Provider Identifier
1629092580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 563
- Practice address
- 2707 L St
Suite 1
Ord, NE 68862-1275 - Phone
- (308) 728-4202
- Fax
- (308) 728-3500
- NPI assigned
- Jul 26, 2006
- Last updated
- Jul 22, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 563 | NE | Primary |
Addresses
Primary practice location
2707 L St
Suite 1
Ord, NE 68862-1275
Mailing address
2707 L St
Suite 1
Ord, NE 68862-1275
Phone (308) 728-4202
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley County Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1629092580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 L ST",
"address_2": "SUITE 1",
"city": "ORD",
"state": "NE",
"postal_code": "688621275",
"telephone_number": "308-728-4202",
"fax_number": "308-728-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 L ST",
"address_2": "SUITE 1",
"city": "ORD",
"state": "NE",
"postal_code": "688621275",
"telephone_number": "308-728-4202",
"fax_number": "308-728-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "ROBERT",
"middle_name": "JAMES",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ord, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.