Individual provider Active NPI

Riley M Gillis, PA

  • Medical Physician Assistant
  • Decatur, GA
National Provider Identifier
1740171040
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
13245 Issued in GA
Practice address
2701 N Decatur Rd
Decatur, GA 30033-5918
Phone
(404) 501-1000
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 13245 GA Primary

Addresses

Primary practice location

2701 N Decatur Rd
Decatur, GA 30033-5918

Mailing address

214 Colonial Homes Dr NW Unit 1307
Atlanta, GA 30309-1542
Phone (813) 454-4722

Other practice location 1

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996
Phone (404) 501-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251028004464 GA Practitioner - Physician Assistant 8325537525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (510) 851-7493

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996
Phone (510) 851-7493

Hospital & facility affiliations

  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13245GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Sep 2, 2025 Accepting new patients
Cep America LLC Current Accepting new patients
Cep America LLC CurrentSince Sep 2, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1740171040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 COLONIAL HOMES DR NW UNIT 1307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091542",
            "telephone_number": "813-454-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Dekalb Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300584996",
            "country_code": "US",
            "telephone_number": "404-501-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "RILEY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "13245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.