Active NPI
Riley James Kiernan
- Student in an Organized Health Care Education/Training Program
- Johnson City, NY
National Provider Identifier
1063325827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 20-P105489-01
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.