Active NPI
Garrett Beau Reilly, PT
- Physical Therapist
- Flagstaff, AZ
National Provider Identifier
1962834895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10448
- Practice address
- 3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972 - Phone
- (928) 774-7106
- NPI assigned
- Aug 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10448 | AZ | Primary |
Addresses
Primary practice location
3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972
Mailing address
119 S Florence St
Apt B
Flagstaff, AZ 86001-5475
Phone (928) 499-7311
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10448 | AZ | MD | Day Training/Habilitation Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1962834895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 S FLORENCE ST",
"address_2": "APT B",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860015475",
"telephone_number": "928-499-7311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 N WINDING BROOK RD",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860010972",
"telephone_number": "928-774-7106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "GARRETT",
"middle_name": "BEAU",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-01",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "10448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
- Rehabilitation Hospital of Northern Arizona LLC
- Janet Reich, RN
- William David Reid, R.T.
- Michael F Reidy, MD
- Sandra Nevills Reiff, LISAC
- Reliable Diagnostic Laboratory LLC
- Reliant Senior Living LLC
- Jamie Lee Resnick, MD
- Resonance Sonography LLC
- Restoration Body Works Wellness and Physical Therapy, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.