Individual provider Active NPI

Lauren Reilly, PT, DPT

  • Physical Therapist
  • Suffolk, VA
National Provider Identifier
1669184149
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP055525T Issued in VA
Practice address
150 Burnetts Way Ste 230
Suffolk, VA 23434-8168
Phone
(757) 942-2022
Fax
(757) 512-8997
NPI assigned
Dec 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 29240 MD
Physical Therapist 225100000X CP055525T VA Primary
Physical Therapist 225100000X 14602 CT
Physical Therapist 225100000X 070.029235 IL

Addresses

Primary practice location

150 Burnetts Way Ste 230
Suffolk, VA 23434-8168

Mailing address

PO Box 412307
Boston, MA 02241-2307
Phone (914) 294-4050

Other practice location 1

1413 Madison Park Dr Unit 100
Glen Burnie, MD 21061-6355
Phone (410) 863-5939

Other practice location 2

3683 Post Rd
Southport, CT 06890-1113
Phone (475) 209-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, CT, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230221002680 MD Practitioner - Physical Therapist in Private Practice 8527430511 Reassigns benefits to 1 organization
I20240905002403 CT Practitioner - Physical Therapist in Private Practice 8527430511 Reassigns benefits to 1 organization
I20260618003609 VA Practitioner - Physical Therapist in Private Practice 8527430511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
4 Oaks Physical Therapy, LLCGroup PAC ID 1759604838, 18 clinicians
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians
Ivyrehab Connecticut IncGroup PAC ID 8325203649, 71 clinicians

Practice addresses (Care Compare)

1413 Madison Park Dr
Suite 100
Glen Burnie, MD 21061-5613
Phone (443) 583-3757

150 Burnetts Way
Suite 230
Suffolk, VA 23434-8168
Phone (757) 942-2022

3683 Post Rd
Southport, CT 06890-1113
Phone (475) 209-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14602CTMDPhysical Therapist
070.029235ILMDPhysical Therapist
29240MDMDPhysical Therapist
CP055525TVAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince May 4, 2026 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist PastSince May 4, 2026 Accepting new patients

Locations

90 Washington St
Norwalk, CT 06854
Phone (475) 273-0583

3683 Post Rd
Southport, CT 06890
Phone (475) 209-8900

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

150 Burnetts Way
Ste 230
Suffolk, VA 23434
Phone (757) 942-2022

Organizations & group practices 4

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": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1669184149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BURNETTS WAY STE 230",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348168",
            "telephone_number": "757-942-2022",
            "fax_number": "757-512-8997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1413 Madison Park Dr Unit 100",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210616355",
            "country_code": "US",
            "telephone_number": "410-863-5939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3683 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "CT",
            "postal_code": "068901113",
            "country_code": "US",
            "telephone_number": "475-209-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "LAUREN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29240",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP055525T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14602",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.029235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.