Thaddeus H Riley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

028637 Issued in GA

Practice address

23702 Hwy 80 E
Statesboro, GA 30458

Phone

(912) 489-4090

Fax

(912) 765-5028

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: thaddeus.riley.p1@direct.familyhealthcare.nextgenshare.com

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.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104874031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "address_2": "PO BOX 957",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30459",
            "telephone_number": "912-489-4090",
            "fax_number": "912-765-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-4090",
            "fax_number": "912-765-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "THADDEUS",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "028637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00351601C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alsiha Riggins, MPH
• Mollie Riggins
• Amy Jo Riggs, RD, LD
• James Lester Riggs, R. PH
• Susan B Riley, NP
• Jose Alfredo Rivera Sepulveda, MD
• Jennifer L Roberson, PTA
• Charlotte Elizabeth Roberts, LPC, MED, NCC, FCT 1
• Tonja Dawn Roberts, LPC
• Ann Robertson, NP

• Family Medicine Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.