Individual provider Active NPI

Shawn G. Riley, D.C.

  • Chiropractor
  • Center, TX
National Provider Identifier
1023232329
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9199 Issued in TX
Practice address
201 San Augustine St
Center, TX 75935-3953
Phone
(936) 598-5200
Fax
(936) 591-0505
NPI assigned
Apr 11, 2007
Last updated
Oct 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9199 TX Primary

Addresses

Primary practice location

201 San Augustine St
Center, TX 75935-3953

Mailing address

201 San Augustine St
Center, TX 75935-3953
Phone (936) 598-5200

Other identifiers 1

IdentifierTypeStateIssuer
608231OtherTXBLUE CROSS OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000957 TX Practitioner - Chiropractic 9537182076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 San Augustine St
Center, TX 75935-3953
Phone (936) 598-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9199TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
S. Riley Chiropractic PLLC Chiropractor CurrentSince Nov 13, 2005 Accepting new patients

Locations

201 San Augustine St
Center, TX 75935
Phone (936) 598-5200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1023232329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SAN AUGUSTINE ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353953",
            "telephone_number": "936-598-5200",
            "fax_number": "936-591-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SAN AUGUSTINE ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353953",
            "telephone_number": "936-598-5200",
            "fax_number": "936-591-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SHAWN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "608231",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.