Riley Tegan Atwell, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2014024221 Issued in MO

Practice address

220 NW Platte Valley Dr
Riverside, MO 64150-9793

Phone

(816) 505-3422

Fax

(816) 505-3312

NPI assigned

Jun 10, 2014

Last updated

Sep 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Riley Tegan Mahn Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serc Rehabilitation Partners, LLC

  dba Serc

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244
  Medicare reassignment Care Compare group NPD
• Serc Rehabilitation Partners, LLC

  dba Serc

  • Physical Therapy Clinic/Center
  • Odessa, MO
  • NPI 1396009833
  NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1821401530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NW PLATTE VALLEY DR",
            "city": "RIVERSIDE",
            "state": "MO",
            "postal_code": "641509793",
            "telephone_number": "816-505-3422",
            "fax_number": "816-505-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWELL",
        "first_name": "RILEY",
        "middle_name": "TEGAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014024221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RILEY",
            "last_name": "MAHN",
            "middle_name": "TEGAN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Diana Jazmin Betancourt, MS, LAT, ATC
• Ali M Bishr, PHARMD
• Alice Marie Blyth, MA, LPC, BCBA, LBA
• Caleb Michael Book, PT, DPT
• Chitra Chinnaswamy, MD

• Physical Therapist in Riverside, MO
• Providers in Riverside, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.