NPIMap

Individual provider Active NPI

Antoinette R Riley, FNP, DCNP

  • Family Nurse Practitioner
  • Atlanta, TX
National Provider Identifier
1659302545
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
630914 Issued in TX
Practice address
1011 S William St
Atlanta, TX 75551-3245
Phone
(903) 796-2868
Fax
(903) 796-0826
NPI assigned
Jul 6, 2006
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 630914 TX Primary
Specialist 174400000X

Addresses

Primary practice location

1011 S William St
Atlanta, TX 75551-3245

Mailing address

PO Box 1326
Marshall, TX 75671-1326
Phone (903) 927-3782

Other practice location 1

3502 Richmond Rd
Texarkana, TX 75503-0705
Phone (903) 223-9911

Other names 1

  • Antoinette Renee Pope Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070111000651 TX Practitioner - Nurse Practitioner 8820098007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Border Health ClinicGroup PAC ID 8820038565, 55 clinicians

Practice addresses (Care Compare)

1011 S William St
Atlanta, TX 75551-3245
Phone (903) 796-2868

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
630914TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Border Health Clinic Specialist CurrentSince Nov 19, 2015 Accepting new patients
East Texas Border Health Clinic Current Accepting new patients
East Texas Border Health Clinic CurrentSince Nov 19, 2015 Accepting new patients
East Texas Border Health Clinic PastSince Sep 21, 2025 Accepting new patients
East Texas Border Health Clinic PastSince Sep 5, 2021 Accepting new patients

Locations

1011 S William St
Atlanta, TX 75551
Phone (903) 796-2868

1400 College Dr
Texarkana, TX 75503
Phone (903) 791-1110

Interoperability endpoints

  • Direct secure messaging: antoinette.riley@gpc.eclinicaldirectplus.com

Organizations & group practices 6

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 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1659302545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S WILLIAM ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755513245",
            "telephone_number": "903-796-2868",
            "fax_number": "903-796-0826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3502 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755030705",
            "country_code": "US",
            "telephone_number": "903-223-9911",
            "fax_number": "903-223-6380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "ANTOINETTE",
        "middle_name": "R",
        "credential": "FNP, DCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "630914",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTOINETTE",
            "last_name": "POPE",
            "middle_name": "RENEE",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, TX

Sources for this page

Verify at the official NPI Registry.