Active NPI
Diana Sue Riley, P.A.
- Physician Assistant
- Mountain Home, AR
National Provider Identifier
1912156068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA207
- Practice address
- 628 Hospital Dr
Suite G-C
Mountain Home, AR 72653-2953 - Phone
- (870) 508-5010
- Fax
- (870) 508-5020
- NPI assigned
- Sep 13, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA207 | AR | Primary |
Addresses
Primary practice location
628 Hospital Dr
Suite G-C
Mountain Home, AR 72653-2953
Mailing address
628 Hospital Dr
Suite G-C
Mountain Home, AR 72653-2953
Phone (870) 508-5010
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA207 | AR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221264000000",
"number": "1912156068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 HOSPITAL DR",
"address_2": "SUITE G-C",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726532953",
"telephone_number": "870-508-5010",
"fax_number": "870-508-5020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 HOSPITAL DR",
"address_2": "SUITE G-C",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726532953",
"telephone_number": "870-508-5010",
"fax_number": "870-508-5020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "DIANA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-13",
"last_updated": "2008-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AR",
"license": "PA207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.