Stryder River Reilly, RXN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN.0994459-NP Issued in CO

Practice address

515 28 3/4 Rd
Grand Junction, CO 81501-5016

Phone

(970) 263-4918

NPI assigned

Jul 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Ketamine West LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Junction, CO
  • NPI 1477287290

  CO

  Medicare reassignment NPD Authorized official
• Harbor Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Junction, CO
  • NPI 1306786082

  Psychiatric/Mental Health

  NPD Authorized official
• Ketamine West LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montrose, CO
  • NPI 1003529728
  NPD Authorized official

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1861780199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HORIZON DR STE 225",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 28 3/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015016",
            "telephone_number": "970-263-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "STRYDER",
        "middle_name": "RIVER",
        "credential": "RXN, PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0994459-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Hope Reed, CAC II
• Michael Thomas Reeder, DO
• Stephanie Reeser, RN
• Sierra Denise Reich
• Gregory C Reicks, D.O.
• Jennie Reiners I
• Karen Juliot Reinertsen, LPC
• Jeffrey R Reinhardt, D.C.
• Lisa Kay Reitz
• Randall Scot Reitz, PHD

• All providers in Grand Junction, CO
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.