NPIMap

Organization Active NPI

Riley-White Inc

  • Durable Medical Equipment & Medical Supplies
  • Russellville, KY
National Provider Identifier
1073680864
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
P06574 Issued in KY
Legal business name
RILEY-WHITE INC
Practice address
153 Park Square NW
Russellville, KY 42276
Phone
(270) 726-7626
Fax
(270) 726-7879
NPI assigned
Nov 29, 2006
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Mr. Jerrold D White, RPHNPI 1518091198
Title
Co Owner Manager
Phone
(270) 726-7626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X P06574 KY Primary

Addresses

Primary practice location

153 Park Square NW
Russellville, KY 42276

Mailing address

153 Park Square NW
Russellville, KY 42276
Phone (270) 726-7626

Other identifiers 1

IdentifierTypeStateIssuer
90170713MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930013452 KY DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company 9032286661 Practice locations: Russellville, KY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Riley-White Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

153 NW Park Sq
Russellville, KY 42276
Phone (270) 726-7626

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1073680864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 PARK SQUARE NW",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "42276",
            "telephone_number": "270-726-7626",
            "fax_number": "270-726-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 PARK SQUARE NW",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "42276",
            "telephone_number": "270-726-7626",
            "fax_number": "270-726-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RILEY-WHITE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO OWNER MANAGER",
        "authorized_official_telephone_number": "270-726-7626",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P06574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90170713",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.