Active NPI
Kevin Riley
- Pharmacist
- Santa Rosa Beach, FL
National Provider Identifier
1235535014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS47122
- Practice address
- 2038 US Highway 98 W
Santa Rosa Beach, FL 32459-5322 - Phone
- (850) 267-1166
- NPI assigned
- Nov 6, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS47122 | FL | Primary |
Addresses
Primary practice location
2038 US Highway 98 W
Santa Rosa Beach, FL 32459-5322
Mailing address
9500 Grand Blvd.
Miramar Beach, FL 32550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS47122 | Other | FL | FLORIDA PHAMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS47122 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets Inc | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
-
- Community/Retail Pharmacy
- Santa Rosa Beach, FL
- NPI 1942431036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415232000000",
"number": "1235535014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 GRAND BLVD.",
"city": "MIRAMAR BEACH",
"state": "FL",
"postal_code": "32550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2038 US HIGHWAY 98 W",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324595322",
"telephone_number": "850-267-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-06",
"last_updated": "2014-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS47122",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA PHAMACIST LICENSE",
"identifier": "PS47122",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.