Active NPI
Malinda K Riley, MPT
- Physical Therapist
- Evansville, IN
National Provider Identifier
1366675100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 005971
- Practice address
- 415 Crosslake Dr
Evansville, IN 47715-8263 - Phone
- (812) 476-0409
- Fax
- (812) 476-1016
- NPI assigned
- Aug 27, 2009
- Last updated
- Feb 17, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05008665A | IN | |
| Physical Therapist | 225100000X | 005971 | KY | Primary |
Addresses
Primary practice location
415 Crosslake Dr
Evansville, IN 47715-8263
Mailing address
PO Box 5629
Evansville, IN 47716-5629
Phone (812) 759-7451
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201020130 | Medicaid | IN | |
| 000000808883 | Other | KY | BLUE CROSS BLUE SHIELD |
| 000000714667 | Other | IN | BLUE CROSS BLUE SHIELD |
| 000000725882 | Other | IN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05008665A | IN | MD | Physical Therapist |
| 005971 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1366675100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5629",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477165629",
"telephone_number": "812-759-7451",
"fax_number": "812-759-7482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 CROSSLAKE DR",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477158263",
"telephone_number": "812-476-0409",
"fax_number": "812-476-1016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "MALINDA",
"middle_name": "K",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-27",
"last_updated": "2020-02-17",
"certification_date": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05008665A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "005971",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201020130",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000808883",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000714667",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000725882",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.