Elly K Riley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO0000002406 Issued in TN

Practice address

294 Summar Dr
Jackson, TN 38301-3915

Phone

(731) 423-1932

NPI assigned

Jun 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Kansas City College of Medicine and Surgery, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Hospital-HuntingdonGroup PAC ID 4082509757, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eriley601955@direct.bmhcc.org

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.

• Baptist Memorial Hospital-Huntingdon

  • Rural Health Clinic/Center
  • Huntingdon, TN
  • NPI 1184114902
  Medicare reassignment Care Compare group NPD
• University of Tennessee

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1780686436
  Medicare reassignment NPD
• Baptist Memorial Hospital-Huntingdon

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356
  NPD
• University of Tennessee

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  NPD
• Baptist Memorial Hospital-Huntingdon

  • Psychiatric Hospital Unit
  • Huntingdon, TN
  • NPI 1013324425
  NPD (past)

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

• Baptist Memorial Hospital-Huntingdon

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356
  Care Compare affiliation

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1063649408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 Rb Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383441733",
            "country_code": "US",
            "telephone_number": "731-986-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "ELLY",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO0000002406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy R Riggins, RD, CLC, IBCLC
• Shelli Denise Riggs, M.A. CCC SLP
• Claire E Rikard, M.D.
• Cody Riley, PTA
• Cory Riley, DNP-CRNA
• Mary Kathryn Riley, RN, FNP
• Retta Riley
• Jacqueline Risley, PHARMD
• Riverside Medical Inc
• Renee Roark, LPC/MHSP

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.