Active NPI
Kimberly A Riley
- Nurse Practitioner
- Eureka, CA
National Provider Identifier
1245837095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F09200740
- Practice address
- 2773 Harris St Ste a
Eureka, CA 95503-4866 - Phone
- (707) 442-1182
- NPI assigned
- Oct 5, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F09200740 | MO | Primary |
Addresses
Primary practice location
2773 Harris St Ste a
Eureka, CA 95503-4866
Mailing address
2000 E Broadway # 264
Columbia, MO 65201-6009
Phone (573) 489-2504
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kriley1647952@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1470 Medical Pkwy
Suite 160
Carson City, NV 89703-4636
Phone (775) 445-7650
Hospital & facility affiliations
- Battle Born Home Health LLC
- Carson Tahoe Regional Medical Center
- Carson Valley Health
- Renown Regional Medical Center
- Banner Churchill Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F09200740 | MO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CTH Physicians Clinic | Current | Accepting new patients | |
| Carson Tahoe Physician Clinics | Current | Accepting new patients |
Locations
2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220
1470 Medical Pkwy
Ste 160
Carson City, NV 89703
Phone (775) 445-7637
901 Medical Center Dr
Ste 203
Dayton, NV 89403
Phone (775) 445-7630
10539 Professional Cir
Ste 200
Reno, NV 89521
Phone (775) 445-7026
Interoperability endpoints
- kriley563860@direct.med.utah.edu
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.
-
- Internal Medicine Physician
- Carson City, NV
- NPI 1023265717
-
- Internal Medicine Physician
- Carson City, NV
- NPI 1306533732
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Fallon, NV
- NPI 1265811251
-
- Home Health Agency
- Carson City, NV
- NPI 1164177051
-
- General Acute Care Hospital
- Carson City, NV
- NPI 1255360160
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Carson City, NV
- NPI 1568281988
Hospital
-
- General Acute Care Hospital
- Reno, NV
- NPI 1124098421
-
- General Acute Care Hospital
- Sparks, NV
- NPI 1932517299
-
- Community/Behavioral Health Agency
- Gardnerville, NV
- NPI 1104482918
Hospital
-
- Critical Access Hospital
- Gardnerville, NV
- NPI 1396799102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1245837095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 E BROADWAY # 264",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016009",
"telephone_number": "573-489-2504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2773 HARRIS ST STE A",
"city": "EUREKA",
"state": "CA",
"postal_code": "955034866",
"telephone_number": "707-442-1182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KIMBERLY",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-05",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "F09200740",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kriley1647952@oc.providencedirect.org",
"affiliation": "N",
"address_1": "2773 Harris St Ste A",
"city": "Eureka",
"state": "CA",
"country_code": "US",
"postal_code": "955034866",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.