Mattie Ann Riley, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P118958 Issued in MS

Practice address

6351 Brown Hooke Rd
Meridian, MS 39305-8994

Phone

(601) 737-5121

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285848077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 CHANDLER RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393059750",
            "telephone_number": "601-483-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 BROWN HOOKE RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393058994",
            "telephone_number": "601-737-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MATTIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P118958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770132",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney C Richardson, DMD
• Laquitha R Ridgeway
• Parker Fulton Rigby, DR.
• Lindsey Rigdon
• Riley Healthcare LLC
• Andrew Mitchell Rinek, MD
• Nancy H. Risher, FNP
• Ritzi RX Medical Wig Clinic
• Michelle L Roark, CNM
• John Roberge

• Licensed Practical Nurse in Meridian, MS
• Providers in Meridian, MS by specialty
• Licensed Practical Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.