NPIMap

Individual provider Active NPI

Sean Patrick Marshall Riley, NURSE PRACTITIONER

  • Family Medicine Physician
  • Camden on Gauley, WV
National Provider Identifier
1548867997
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104996 Issued in WV
Practice address
10003 Webster Rd
Camden on Gauley, WV 26208-7713
Phone
(304) 226-5725
NPI assigned
Oct 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104996 WV Primary

Addresses

Primary practice location

10003 Webster Rd
Camden on Gauley, WV 26208-7713

Mailing address

99 Cracker Barrel Dr Ste 100
Barboursville, WV 25504-1650
Phone (304) 525-7851

Other practice location 1

511 Morris St
Charleston, WV 25301-1326
Phone (304) 525-7851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000347 WV Practitioner - Nurse Practitioner 3476952540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestera Center for Mental Health Services IncGroup PAC ID 9234029307, 45 clinicians

Practice addresses (Care Compare)

511 Morris St
Charleston, WV 25301-1326
Phone (304) 525-7851

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camden on Gauley Medical Center Inc. Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center, Inc. Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Prestera Center for Mental Health Services Inc Family Medicine CurrentSince Apr 25, 2022 Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 12, 2021 Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center, Inc Current Accepting new patients
Camden on Gauley Medical Center Inc CurrentSince Apr 12, 2021 Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Apr 25, 2022 Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center Inc Current Accepting new patients
Camden on Gauley Medical Center, Inc Current Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

10003 Webster Rd
Camden on Gly, WV 26208
Phone (304) 266-5725

511 Morris St
Charleston, WV 25301
Phone (304) 341-0511

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

4020 US Route 60
Huntington, WV 25705
Phone (304) 399-1177

55 Donohoe Dr
Huntington, WV 25705

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 20

Hospital & facility affiliations 11

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": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1548867997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CRACKER BARREL DR STE 100",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041650",
            "telephone_number": "304-525-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SEAN PATRICK",
        "middle_name": "MARSHALL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "104996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden on Gauley, WV

Sources for this page

Verify at the official NPI Registry.