Paul R Reilly, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6328 Issued in TN

Practice address

24 Physicians Dr
Jackson, TN 38305

Phone

(731) 661-9825

Fax

(731) 668-6757

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jackson Clinic PA

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038

  Physical Therapist

  NPD (past)
• Lift Therapy, Inc.

  • Rehabilitation Clinic/Center
  • Jackson, TN
  • NPI 1114267986
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699832238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT6328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375781",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veldon Flynn Reedy, L.C.S.W.
• Debra Reese Hill
• Regional Cardiology Consultants, PC
• Regional Dental Associates
• Regional Heart & Vein Clinic, PLLC
• Adam David Reinhard
• Amanda Reiter, MD
• Jonathan Renfroe, PHARM.D.
• Retina Consultants, P.C.
• Revelation of Hope Counseling Services, LLC

• Physical Therapist in Jackson, TN
• Providers in Jackson, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.