KEVIN O'REILLY NPI 1396229811

NPI Information

  • NPI: 1396229811
  • Provider Name: KEVIN O'REILLY
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 405 ELLIS AVE
    MARYVILLE, TN
    ZIP 37804
  • Phone: (865) 980-5377

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NPI Details

Kevin O'reilly is a psychiatric/mental health nurse practitioner in Maryville, TN with 8 years of experience. Kevin O'reilly NPI is 1396229811. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduation Year:2018

The provider's business location address is:

405 ELLIS AVE
MARYVILLE, TN
ZIP 37804-823
Phone: (865) 980-5377
Fax: (865) 980-5376

The NPI 1396229811 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2018 and was last updated on 10/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health24725TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q044395MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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