Individual provider Active NPI

Lorie Lee Riley, DPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1356658447
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25671 Issued in FL
Practice address
11603 Sheldon Rd
Tampa, FL 33626-4306
Phone
(813) 792-9843
Fax
(813) 792-9853
NPI assigned
Sep 10, 2010
Last updated
Feb 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25671 FL Primary

Addresses

Primary practice location

11603 Sheldon Rd
Tampa, FL 33626-4306

Mailing address

21756 State Road 54
Suite 102
Lutz, FL 33549-2905
Phone (813) 345-4558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000063 FL Practitioner - Physical Therapist in Private Practice 5092956771 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jin M Kim D O P a CurrentSince Oct 28, 2014 Accepting new patients

Locations

10205 W Hillsborough Ave
Ste B
Tampa, FL 33615
Phone (813) 884-2300

11357 Countryway Blvd
Tampa, FL 33626
Phone (813) 925-8800

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1356658447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54",
            "address_2": "SUITE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "813-345-4558",
            "fax_number": "813-949-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11603 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264306",
            "telephone_number": "813-792-9843",
            "fax_number": "813-792-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "LORIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.