Shannon Riley, VICE PRESIDENT OF OP

Primary specialty

Laboratory Management Specialist/TechnologistTaxonomy code 246QL0900X

Practice address

570 Memorial Cir Ste 110
Ormond Beach, FL 32174-5063

Phone

(386) 951-5571

Fax

(386) 287-5776

NPI assigned

Mar 3, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Optimus Labs LLC

  • Medical Laboratory Technician
  • Ormond Beach, FL
  • NPI 1740949387
  NPD Authorized official
• Florida Pain Specialists PLLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1285182659
  NPD

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1013664796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 MEMORIAL CIR STE 110",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745063",
            "telephone_number": "386-951-5571",
            "fax_number": "386-287-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 MEMORIAL CIR STE 110",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745063",
            "telephone_number": "386-951-5571",
            "fax_number": "386-287-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SHANNON",
        "credential": "VICE PRESIDENT OF OP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0900X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2251415",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contactus@optimus-lab.com",
            "affiliation": "N",
            "endpointDescription": "hipaa compliant direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "570 Memorial Cir Ste 110",
            "city": "Ormond Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321745063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Richards
• Oksana Richards, PA
• Tabitha Richards, MED, RD, LD/N
• Jocelyn Riden
• Lisa M Rieck
• Rise Health Chiropractic, LLC
• Hector L Rivera, M.D.
• Anna M Robbins
• Rena Michel Robbins, M.D.
• Katia Robelo, APRN

• Pathology Specialist/Technologist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Pathology Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.