Individual provider Active NPI

Terry Riley, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1689749970
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-24573 Issued in CA
Practice address
4150 Mission Blvd Ste 145
San Diego, CA 92109-5055
Phone
(858) 272-3898
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-24573 CA Primary

Addresses

Primary practice location

4150 Mission Blvd Ste 145
San Diego, CA 92109-5055

Mailing address

8555 Station Village LN
Ste B
San Diego, CA 92108-6567
Phone (619) 284-3883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220114001882 CA Practitioner - Chiropractic 2860884269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spence Chiropractic Corp, Apc.Group PAC ID 7517029309, 3 clinicians

Practice addresses (Care Compare)

8555 Station Village LN
Suite B
San Diego, CA 92108-6567
Phone (619) 284-3883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-24573CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spence Chiropractic Corp, Apc. Chiropractor CurrentSince Oct 7, 2021 Accepting new patients

Locations

8555 Station Village Ln
Ste B
San Diego, CA 92108
Phone (619) 284-3883

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1689749970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 STATION VILLAGE LN",
            "address_2": "STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921086567",
            "telephone_number": "619-284-3883",
            "fax_number": "619-295-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 MISSION BLVD STE 145",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095055",
            "telephone_number": "858-272-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-24573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.