Bonnie Jean Riley, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103017 Issued in NC

Practice address

1061 Harmon Avenue
Fort Stewart, GA 31314-5274

Phone

(912) 435-5872

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1245204767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVENUE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145274",
            "telephone_number": "912-435-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVENUE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145274",
            "telephone_number": "912-435-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J Rich, MD
• Rodney A. Richards, DDS
• Tyra Richardson, LPN
• Christopher Joseph Rider, PTA
• Alice Riley, CPHT
• Ursula Shauntay Riley, LCSW, LMSW
• Arturo Rincones, EMT
• Meghan Rinehart
• Patricia Risner
• George Alfred Rivera Medina, D.C.

• Physician Assistant in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.