NPIMap

Organization Active NPI

Riley Physical Therapy, Inc

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1356814826
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RILEY PHYSICAL THERAPY, INC
Practice address
650 Olive St
Shreveport, LA 71104-2210
Phone
(318) 537-4376
NPI assigned
Jan 8, 2019
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Mr. Jason C Riley, MPT, ATC, LAT, CKTPNPI 1861444200
Title
Physical Therapist/President
Phone
(318) 537-4376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

650 Olive St
Shreveport, LA 71104-2210

Mailing address

214 Winkler Way
Monroe, LA 71203-6527
Phone (318) 537-4376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200310001106 LA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981032711 Receives reassigned benefits from 1 practitioner
Practice locations: Shreveport, LA
O20260317002543 TX Part B Supplier - Clinic/Group Practice 4981032711 Receives reassigned benefits from 7 practitioners
Practice locations: Henderson, TX

National Provider Directory

National Provider Directory

Locations

650 Olive St
Shreveport, LA 71104
Phone (318) 302-6000

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1356814826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 WINKLER WAY",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712036527",
            "telephone_number": "318-537-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042210",
            "telephone_number": "318-537-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RILEY PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/PRESIDENT",
        "authorized_official_telephone_number": "318-537-4376",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT, ATC, LAT, CKTP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.