Individual provider Active NPI

Riley Jo Larner

  • Physician Assistant
  • Novi, MI
National Provider Identifier
1194485904
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011610 Issued in MI
Practice address
26850 Providence Pkwy Ste 350
Novi, MI 48374-1261
Phone
(248) 662-4110
Fax
(248) 662-4120
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 5601011610 MI Primary

Addresses

Primary practice location

26850 Providence Pkwy Ste 350
Novi, MI 48374-1261

Mailing address

26850 Providence Pkwy Ste 350
Novi, MI 48374-1261
Phone (248) 662-4110

Other practice location 1

24548 W Warren St
Dearborn Heights, MI 48127-2105
Phone (313) 561-3386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230626003251 MI Practitioner - Physician Assistant 7810355658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Gi Solutions PLLCGroup PAC ID 0840657953, 12 clinicians

Practice addresses (Care Compare)

27620 Farmington Rd
Suite 109D
Farmington Hills, MI 48334-3367
Phone (248) 557-9650

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: rpavel1250497@epic00.shdirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1194485904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 350",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741261",
            "telephone_number": "248-662-4110",
            "fax_number": "248-662-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 350",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741261",
            "telephone_number": "248-662-4110",
            "fax_number": "248-662-4120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24548 W Warren St",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481272105",
            "country_code": "US",
            "telephone_number": "313-561-3386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARNER",
        "first_name": "RILEY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.