Individual provider Active NPI

Emily Joy Riley, PNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1578867164
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2010041912 Issued in MO
Practice address
5114 Mid America PLZ
Ste 2C
Saint Louis, MO 63129-0003
Phone
(314) 859-4000
Fax
(314) 273-4110
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2010041912 MO Primary

Addresses

Primary practice location

5114 Mid America PLZ
Ste 2C
Saint Louis, MO 63129-0003

Mailing address

PO Box 7412051
Chicago, IL 60674-2051
Phone (314) 859-4000

Other identifiers 1

IdentifierTypeStateIssuer
424381705MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240427000032 MO Practitioner - Nurse Practitioner 6002256856 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010041912MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pediatrics LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

5114 Mid America Plz
Ste 2C
Saint Louis, MO 63129
Phone (314) 859-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1578867164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412051",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742051",
            "telephone_number": "314-859-4000",
            "fax_number": "314-273-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 MID AMERICA PLZ",
            "address_2": "STE 2C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290003",
            "telephone_number": "314-859-4000",
            "fax_number": "314-273-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "EMILY",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2010041912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424381705",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "5114 Mid America Plz",
            "address_2": "STE 2C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631290003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.