Elizabeth Riley, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Indianapolis, IN
NPI 1134523913 · NPPES record last updated Nov 24, 2014
Key facts
- NPI
- 1134523913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 71005119A (IN)
- Practice address
- 8401 Harcourt Road
St Vincent Stress Center
Indianapolis, IN 46260 - Phone
- (317) 338-4600
- NPI assigned
- Oct 22, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Grossmont Hospital Corporation
Practice addresses (Care Compare)
5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-4475
Hospital & facility affiliations
- Grossmont Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190710000896 | CA | Practitioner - Nurse Practitioner | 9830412733 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71005119A | IN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian P. Miller Medical Doctor Inc. | Psychiatric/Mental Health | Current |
Accepting new patients |
| Brian P. Miller, M.D., a Professional Corporation | Current |
Accepting new patients | |
| Grossmont Hospital Corporation | Current |
Accepting new patients |
Locations
5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711
7850 Vista Hill Ave
San Diego, CA 92123
Phone (858) 836-8434
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 71005119A | IN | Yes |
Addresses
Primary practice location
8401 Harcourt Road
St Vincent Stress Center
Indianapolis, IN 46260
Mailing address
10330 N Meridian St
Suite 201
Indianapolis, IN 46290-1024
Other providers in Indianapolis, IN
- Allison Riley
- Amber Nicole Riley
- Blane Riley
- Charlene Riley
- Clint William Riley
- Elizabeth Grace Riley
- Jason Donald Riley
- Jeannine Riley
- Kevin M Riley
- Mackenzie Riley
All providers in Indianapolis, IN · Psychiatric/Mental Health Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.