Individual provider Active NPI

Rebecca Lynn Rielly, RN

  • Registered Nurse
  • Liberty, NY
National Provider Identifier
1851642730
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
634903 Issued in NY
Practice address
3 Timberwolf Rd
Unit 57
Liberty, NY 12754-3348
Phone
(845) 701-3092
NPI assigned
Oct 2, 2012
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 634903 NY Primary

Addresses

Primary practice location

3 Timberwolf Rd
Unit 57
Liberty, NY 12754-3348

Mailing address

3 Timberwolf Rd
Unit 57
Liberty, NY 12754-3348
Phone (845) 701-3092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
634903NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1851642730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 TIMBERWOLF RD",
            "address_2": "UNIT 57",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127543348",
            "telephone_number": "845-701-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TIMBERWOLF RD",
            "address_2": "UNIT 57",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127543348",
            "telephone_number": "845-701-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIELLY",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "634903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.