Riley Pyne Warner, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6750 S Highland Dr
Cottonwood Heights, UT 84121-3019

Phone

(801) 685-7246

NPI assigned

Jul 19, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Male Fertility and Peyronie'S Clinic

  • Urology Physician
  • Orem, UT
  • NPI 1013522564

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1595116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1104434893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 E 200 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974915",
            "telephone_number": "801-615-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 S HIGHLAND DR",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213019",
            "telephone_number": "801-685-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92 Kansas St Apt F23",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923735429",
            "country_code": "US",
            "telephone_number": "801-615-3807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "RILEY",
        "middle_name": "PYNE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-19",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Joanne Walling
• Carra M Ward, CMHCI
• Celeste Ward
• David Paul Warner, PHD
• Mikalya Warren
• Zackary Warren
• Wasatch Recovery Treatment Center LLC
• Kari Watchorn
• Stephen Alexander Weaver, RN

• Physician Assistant in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.