NPIMap

Organization Active NPI

Joanna Lynn Riley

  • Multi-Specialty Clinic/Center
  • Odessa, TX
National Provider Identifier
1346507209
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
109122 Issued in TX
Legal business name
JOANNA LYNN RILEY
Practice address
2760 N Grandview Ave
Suite a
Odessa, TX 79762-6953
Phone
(432) 552-7034
Fax
(432) 552-7165
NPI assigned
Apr 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Authorized official

Name
Ms. Joanna Riley, LOT
Title
Owner
Phone
(432) 638-4544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 109122 TX Primary

Addresses

Primary practice location

2760 N Grandview Ave
Suite a
Odessa, TX 79762-6953

Mailing address

PO Box 14774
Odessa, TX 79768-4774
Phone (432) 638-4544

Other identifiers 1

IdentifierTypeStateIssuer
1255617270OtherTXTYPE 1 NPI

National Provider Directory

National Provider Directory

Locations

4311 Andrews Hwy
Midland, TX 79703
Phone (432) 520-5600

1514 N Grandview Ave
Ste A
Odessa, TX 79761
Phone (432) 638-4544

2760 N Grandview Ave
Ste A
Odessa, TX 79762
Phone (432) 552-7034

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347580800000",
    "number": "1346507209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14774",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797684774",
            "telephone_number": "432-638-4544",
            "fax_number": "432-362-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 N GRANDVIEW AVE",
            "address_2": "SUITE A",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797626953",
            "telephone_number": "432-552-7034",
            "fax_number": "432-552-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA LYNN RILEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-09-14",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-638-4544",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LOT"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": "109122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1255617270",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.