Mari A Riley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-13163 Issued in ID

Practice address

875 S Vanguard Way
Meridian, ID 83642-7552

Phone

(208) 463-3000

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. Mari Ann Gardner Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Clinical Biomechanics of Posture (CBP) of Colorado a LLC

  • Rehabilitation Chiropractor
  • Windsor, CO
  • NPI 1992871859
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1821108317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-463-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427552",
            "telephone_number": "208-463-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 E Hawaii Ave",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836866011",
            "country_code": "US",
            "telephone_number": "208-463-3000",
            "fax_number": "208-463-3044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MARI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR49628",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "46613",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-13163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34576000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mari.riley@sal.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "875 S Vanguard Way",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836427552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARI",
            "last_name": "GARDNER",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandon Keith Riebling, D.C.
• Anne E. Riffle, M.D.
• Amy Faye Rigenhagen
• Garren Riggers, DDS
• Brett Riley
• Melissa Rios, CSFA
• Raul Rios, PA-C, ATC
• Rise & Thrive Counseling PLLC
• Rise Together, LLC
• Rising Hope Trauma Counseling

• Family Medicine Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.