Active NPI
James Riley
- Physical Therapy Assistant
- Lake Placid, FL
National Provider Identifier
1548776701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 27839
- Practice address
- 1297 US 27 N
Lake Placid, FL 33852-7907 - Phone
- (863) 465-0568
- NPI assigned
- Dec 22, 2017
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 27839 | FL | Primary |
Addresses
Primary practice location
1297 US 27 N
Lake Placid, FL 33852-7907
Mailing address
1297 US 27 N
Lake Placid, FL 33852-7907
Other practice location 1
1927 US 27 S
Lake Placid, FL 33852
Phone (813) 624-7672
Other practice location 2
1297 US 27 N
Lake Placid, FL 33852-7907
Phone (863) 465-0568
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27-1628874 | Other | NY | MEDICARE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27839 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1548776701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1297 US 27 N",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338527907",
"fax_number": "863-465-0568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1297 US 27 N",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338527907",
"telephone_number": "863-465-0568"
}
],
"practiceLocations": [
{
"address_1": "1927 US 27 S",
"address_purpose": "LOCATION",
"city": "Lake Placid",
"state": "FL",
"postal_code": "33852",
"country_code": "US",
"telephone_number": "813-624-7672",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1297 US 27 N",
"address_purpose": "LOCATION",
"city": "Lake Placid",
"state": "FL",
"postal_code": "338527907",
"country_code": "US",
"telephone_number": "863-465-0568",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RILEY",
"first_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "27839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "27-1628874",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Placid, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.