Active NPI
Nakita Riley
- Dentist
- Little Rock, AR
National Provider Identifier
1306475157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4482
- Practice address
- 820 N University Ave
Little Rock, AR 72205-2920 - Phone
- (501) 664-1733
- NPI assigned
- Apr 3, 2020
- Last updated
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4482 | AR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
820 N University Ave
Little Rock, AR 72205-2920
Mailing address
16000 Rushmore Ave Apt 5206
Little Rock, AR 72223-7018
Other practice location 1
4301 W Markham St # 624
Little Rock, AR 72205-7101
Phone (501) 686-8089
Other practice location 2
1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-1874
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200715001989 | AR | Order and Referring Only - Dentist | 4688098270 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4482 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1306475157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16000 RUSHMORE AVE APT 5206",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722237018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 N UNIVERSITY AVE",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722052920",
"telephone_number": "501-664-1733"
}
],
"practiceLocations": [
{
"address_1": "4301 W Markham St # 624",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722057101",
"country_code": "US",
"telephone_number": "501-686-8089",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Childrens Way",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722023500",
"country_code": "US",
"telephone_number": "501-364-1874",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RILEY",
"first_name": "NAKITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-03",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4482",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.