Individual provider Active NPI

Phillip J Riley, DPM

  • Podiatrist
  • Johnson City, TN
National Provider Identifier
1043284391
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD653 Issued in TN
Practice address
301 Med Tech Pkwy Ste 106
Johnson City, TN 37604-2631
Phone
(423) 434-6410
Fax
(423) 232-8576
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD653 TN Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 106
Johnson City, TN 37604-2631

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 434-6410

Other practice location 1

301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631
Phone (423) 794-5590

Other practice location 2

303 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2392
Phone (423) 282-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051220000578 TN Practitioner - Podiatry 7810919735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue100
Removal of nail tissue935
Removal or shaving of skin growth268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD653TNMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation CurrentSince Jun 15, 2008 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Apr 6, 2023 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Apr 1, 2023 Accepting new patients
Medical Education Assistance Corporation Past Accepting new patients

Locations

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239

301 Med Tech Pkwy
Ste 120
Johnson City, TN 37604
Phone (423) 794-5590

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

325 N State of Franklin Rd
Fl 3
Johnson City, TN 37604
Phone (423) 439-7201

303 Med Tech Pkwy
Ste 100
Johnson City, TN 37604
Phone (423) 282-5611

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

301 Med Tech Pkwy
Ste 106
Johnson City, TN 37604
Phone (423) 434-6410

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

Interoperability endpoints

  • Direct secure messaging: phillipriley@sofha.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1043284391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-434-6410",
            "fax_number": "423-232-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042631",
            "telephone_number": "423-434-6410",
            "fax_number": "423-232-8576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Med Tech Pkwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042631",
            "country_code": "US",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 Med Tech Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042392",
            "country_code": "US",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "MD653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.