Kenneth William Riley Jr.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

10953 Park Rd.
Charlotte, NC 28226

Phone

(910) 624-7983

NPI assigned

May 31, 2018

Last updated

Apr 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1427540012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N TRYON ST STE 1600",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282020213",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10953 PARK RD.",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "910-624-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "KENNETH",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-04-13",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301435",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lindley Riley, M.D.
• Elizabeth Hughes Riley, MA, LCMHC, NCC
• John F. Riley, PH.D.
• Jurell Kirice Riley, DNP
• Kathryn Parker Riley, DMD
• Kimberly Riley
• Lorree Gatch Riley, MA, LPC
• Mackenzie Riley, BCBA
• Michael Riley
• Monika Riley

• Behavior Analyst in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.