Individual provider Active NPI

Scott Frederick Riley, PA-C

  • Physician Assistant
  • Henderson, NC
National Provider Identifier
1437890134
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
120 Charles Rollins Rd Ste 102
Henderson, NC 27536-2882
Phone
(252) 436-1314
NPI assigned
Apr 5, 2022
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 0010-12217 NC

Addresses

Primary practice location

120 Charles Rollins Rd Ste 102
Henderson, NC 27536-2882

Mailing address

26 Garden Hills CT
Durham, NC 27712-2187
Phone (919) 500-6866

Other practice location 1

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 438-4143

Other practice location 2

615 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 599-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603001646 NC Practitioner - Physician Assistant 2264810290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Charles Rollins Rd
Henderson, NC 27536-2882

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 436-1148

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-12217NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices LLC CurrentSince Jul 1, 2022 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Jul 1, 2022 Accepting new patients
DLP Person Physician Practices LLC Orthopaedic Surgery CurrentSince Jul 6, 2022 Accepting new patients

Locations

120 Charles Rollins Rd
Ste 102
Henderson, NC 27536
Phone (252) 436-0440

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

503 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-4802

601 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: scott.riley.1@20247.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1437890134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GARDEN HILLS CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277122187",
            "telephone_number": "919-500-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHARLES ROLLINS RD STE 102",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362882",
            "telephone_number": "252-436-1314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "566 Ruin Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275362927",
            "country_code": "US",
            "telephone_number": "252-438-4143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Roxboro",
            "state": "NC",
            "postal_code": "275734629",
            "country_code": "US",
            "telephone_number": "336-599-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SCOTT",
        "middle_name": "FREDERICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-08-01",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "0010-12217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.