Individual provider Active NPI

Michael William Riker, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Knoxville, TN
National Provider Identifier
1760505622
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
51244 Issued in TN
Practice address
12023 Mallard Bay Dr
Knoxville, TN 37922-9357
Phone
(901) 337-8911
NPI assigned
Apr 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006023041 MO
Emergency Medicine Physician 207P00000X 51244 TN
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 51244 TN Primary
Pediatrics Physician 208000000X 51244 TN

Addresses

Primary practice location

12023 Mallard Bay Dr
Knoxville, TN 37922-9357

Mailing address

12023 Mallard Bay Dr
Knoxville, TN 37922-9357
Phone (901) 337-8911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002775 TN Practitioner - Emergency Medicine 5890859060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

2018 Clinch Ave
Knoxville, TN 37916-2301
Phone (865) 541-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51244TNMDEmergency Medicine Physician
2006023041MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Mar 11, 2024 Accepting new patients

Locations

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

2018 Clinch Ave
Knoxville, TN 37916
Phone (865) 541-8000

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": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1760505622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12023 MALLARD BAY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379229357",
            "telephone_number": "901-337-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12023 MALLARD BAY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379229357",
            "telephone_number": "901-337-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIKER",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2006023041",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "51244",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "51244",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "51244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.