Individual provider Active NPI

Wayne Leroy Riley

  • Child Physical Disabilities Respite Care
  • Grand Forks, ND
National Provider Identifier
1043190812
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Physical Disabilities Respite CareTaxonomy code 385HR2065X
Practice address
1628 Lewis Blvd
Grand Forks, ND 58203-1639
Phone
(701) 740-0470
NPI assigned
Sep 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Physical Disabilities Respite Care 385HR2065X ND Primary

Addresses

Primary practice location

1628 Lewis Blvd
Grand Forks, ND 58203-1639

Mailing address

1628 Lewis Blvd
Grand Forks, ND 58203-1639
Phone (701) 740-0470

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1043190812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 LEWIS BLVD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582031639",
            "telephone_number": "701-740-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 LEWIS BLVD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582031639",
            "telephone_number": "701-740-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "WAYNE",
        "middle_name": "LEROY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.