Individual provider Active NPI

Terri Lynn Rielley, REGISTERED NURSE

  • Registered Nurse
  • Crystal Springs, MS
National Provider Identifier
1083224042
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
778817 Issued in MS
Practice address
105 Cedar LN
Crystal Springs, MS 39059-8905
Phone
(601) 754-7115
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 778817 MS Primary

Addresses

Primary practice location

105 Cedar LN
Crystal Springs, MS 39059-8905

Mailing address

105 Cedar LN
Crystal Springs, MS 39059-8905
Phone (601) 754-7115

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
778817MSMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1083224042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CEDAR LN",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390598905",
            "telephone_number": "601-754-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CEDAR LN",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390598905",
            "telephone_number": "601-754-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIELLEY",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "778817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.