Pamela Rae Deane Riley, AUD., CCC-A

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

23002137A Issued in IN

Practice address

919 E Jefferson Blvd Ste 104
South Bend, IN 46617-3115

Phone

(574) 232-5815

Fax

(574) 289-4327

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154432748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 E JEFFERSON BLVD STE 104",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173115",
            "telephone_number": "574-232-5815",
            "fax_number": "574-289-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 E JEFFERSON BLVD STE 104",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173115",
            "telephone_number": "574-232-5815",
            "fax_number": "574-289-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "PAMELA",
        "middle_name": "RAE DEANE",
        "name_prefix": "Dr.",
        "credential": "AUD., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IN",
            "license": "23002137A",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "3501002824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER",
            "identifier": "000000247031",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Alan Richter, MD
• Sally Richthammer
• Rida Transportation Inc.
• Jean Rienks, RN
• Cheryl Riewe, RN, NP
• Robert John Riley, M.D.
• Nicole Davis Riordan, M.D.
• Risser Endodontics P.C.
• Lori F Risser, DR
• Scott Elliot Risser, DDS MSD

• Audiologist-Hearing Aid Fitter in South Bend, IN
• Providers in South Bend, IN by specialty
• Audiologist-Hearing Aid Fitter in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.