Active NPI
Kimberly Anastasia Riley, MPT,CLT
- Physical Therapist
- Peoria, IL
National Provider Identifier
1821273863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.028846
- Practice address
- 4809 N Sheridan Rd
Peoria, IL 61614-5927 - Phone
- (309) 431-1357
- Fax
- (309) 410-3050
- NPI assigned
- Jan 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.028846 | IL | Primary |
Addresses
Primary practice location
4809 N Sheridan Rd
Peoria, IL 61614-5927
Mailing address
414 Bittersweet Ave
Germantown Hills, IL 61548-8643
Phone (309) 431-1357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.028846 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1821273863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 BITTERSWEET AVE",
"city": "GERMANTOWN HILLS",
"state": "IL",
"postal_code": "615488643",
"telephone_number": "309-431-1357",
"fax_number": "309-410-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4809 N SHERIDAN RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145927",
"telephone_number": "309-431-1357",
"fax_number": "309-410-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KIMBERLY",
"middle_name": "ANASTASIA",
"credential": "MPT,CLT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-09",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.028846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.