Individual provider Active NPI

Riley James Kiernan

  • Student in an Organized Health Care Education/Training Program
  • Johnson City, NY
National Provider Identifier
1063325827
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
20-P105489-01 Issued in NY
Practice address
345 Main St
Johnson City, NY 13790-2050
Phone
(607) 763-6775
NPI assigned
Sep 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 20-P105489-01 NY Primary

Addresses

Primary practice location

345 Main St
Johnson City, NY 13790-2050

Mailing address

9042 State Route 38
Newark Valley, NY 13811-2608
Phone (516) 350-1837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1063325827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9042 STATE ROUTE 38",
            "city": "NEWARK VALLEY",
            "state": "NY",
            "postal_code": "138112608",
            "telephone_number": "516-350-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902050",
            "telephone_number": "607-763-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "RILEY",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "20-P105489-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.