Mallory Lynn Reiber, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160009119 Issued in IL

Practice address

1051 W South St
Kewanee, IL 61443-8354

Phone

(217) 871-9181

NPI assigned

Feb 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1669910097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 PULASKI ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562902",
            "telephone_number": "217-871-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W SOUTH ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614438354",
            "telephone_number": "217-871-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIBER",
        "first_name": "MALLORY",
        "middle_name": "LYNN",
        "credential": "ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096004692",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160009119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Rapps, DPT
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• Regional Family Health Center
• Regional Health Partners, LLC
• Stephen L Rider, DDS
• Karlynn Roecker, PHARMACIST
• Royal Hco, LLC
• Royal Hco, LLC
• Stephanie Rusk

• Physical Therapy Assistant in Kewanee, IL
• Providers in Kewanee, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.