Shannon B Reilly, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F430268 Issued in NY

Practice address

5008 Brittonfield Pkwy
Suite 700
East Syracuse, NY 13057-9248

Phone

(315) 472-7504

Fax

(315) 479-8639

NPI assigned

Jan 13, 2006

Sex

Female

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

Other names 1

• Shannon B Daly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

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.

• Charles K Friedman DO PA

  • Interventional Pain Medicine Physician
  • St Petersburg, FL
  • NPI 1982622775
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1851370118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-472-7504",
            "fax_number": "315-479-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-472-7504",
            "fax_number": "315-479-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANNON",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F430268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02648126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "DALY",
            "middle_name": "B",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheruku B Reddy, MD
• Deepika Reddy, D.D.S
• Dennis W Reedy, MD
• Refined Aesthetics and Plastic Surgery of Ny, P.C.
• Rehabworx Physical Medicine and Rehabilitation, PLLC
• Vanna A Reisman, CNM
• Philip A Remillard, M.D.
• Rachel Renaud
• Joshua Reyes
• Heather Jo Rice

• Nurse Practitioner in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.