Individual provider Active NPI

Venetia Constantine Reilly, PT

  • Physical Therapist
  • Merrimack, NH
National Provider Identifier
1811061005
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0869 Issued in NH
Practice address
11 Continental Blvd Ste a
Merrimack, NH 03054-4341
Phone
(603) 424-1950
Fax
(603) 424-4749
NPI assigned
Nov 20, 2006
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0869 NH Primary

Addresses

Primary practice location

11 Continental Blvd Ste a
Merrimack, NH 03054-4341

Mailing address

11 Continental Blvd Ste a
Merrimack, NH 03054-4341
Phone (603) 424-1950

Other identifiers 2

IdentifierTypeStateIssuer
3081235MedicaidNH
0869OtherNHPT LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190128001361 FL Practitioner - Physical Therapist in Private Practice 0042557100 Reassigns benefits to 1 organization
I20190612000371 NH Practitioner - Physical Therapist in Private Practice 0042557100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DTS Inc Therapy Rehab and ExerciseGroup PAC ID 9739414798, 4 clinicians

Practice addresses (Care Compare)

11 Continental Blvd
Suite a
Merrimack, NH 03054-4341
Phone (603) 424-1950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DTS, Inc. Therapy, Rehab & Exercise Physical Therapist CurrentSince May 16, 2022 Accepting new patients
F.I.T. PT, LLC Physical Therapist CurrentSince Dec 5, 2018 Accepting new patients

Locations

950 Peninsula Corporate Cir
Ste 3004
Boca Raton, FL 33487
Phone (561) 501-1983

11 Continental Blvd
Ste A
Merrimack, NH 03054
Phone (603) 424-1950

9 Executive Park Dr
Ste 100
Merrimack, NH 03054
Phone (603) 424-1950

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1811061005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CONTINENTAL BLVD STE A",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030544341",
            "telephone_number": "603-424-1950",
            "fax_number": "603-424-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CONTINENTAL BLVD STE A",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030544341",
            "telephone_number": "603-424-1950",
            "fax_number": "603-424-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "VENETIA",
        "middle_name": "CONSTANTINE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "0869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3081235",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE #",
            "identifier": "0869",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimack, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.