Individual provider Active NPI

Jillian Catherine Riley, NP

  • Family Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1063218063
Registry record updated May 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30008 Issued in SC
Practice address
1112 N Main St
Summerville, SC 29483-7315
Phone
(843) 212-8080
NPI assigned
Feb 20, 2025
Last updated
May 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30008 SC Primary

Addresses

Primary practice location

1112 N Main St
Summerville, SC 29483-7315

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000089 SC Practitioner - Nurse Practitioner 5395261952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1112 N Main St
Summerville, SC 29483-7315
Phone (843) 212-8080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30008SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 19, 2025 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 19, 2025 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

8536 Palmetto Commerce Pkwy
Ste 501
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

1112 N Main St
Summerville, SC 29483
Phone (843) 212-8080

Interoperability endpoints

  • Direct secure messaging: jroy1374616@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748044800000",
    "number": "1063218063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837315",
            "telephone_number": "843-212-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JILLIAN",
        "middle_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-05-24",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.