Individual provider Active NPI

Charles Timothy Riney, PSY.D.

  • Clinical Psychologist
  • Lilburn, GA
National Provider Identifier
1942494711
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003119 Issued in GA
Practice address
630 Hillcrest Rd NW Ste 400
Lilburn, GA 30047-6893
Phone
(678) 769-4088
NPI assigned
Sep 4, 2007
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY003119 GA Primary

Addresses

Primary practice location

630 Hillcrest Rd NW Ste 400
Lilburn, GA 30047-6893

Mailing address

630 Hillcrest Rd NW Ste 400
Lilburn, GA 30047-6893
Phone (678) 769-4088

Other practice location 1

317 W Hill St Ste 204D
Decatur, GA 30030-4368
Phone (678) 769-4088

Other names 1

  • C. Timothy Riney Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000283 GA Practitioner - Clinical Psychologist 9133219272 Reassigns benefits to 1 organization
Practice locations: Lilburn, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

630 Hillcrest Rd NW
Suite 400
Lilburn, GA 30047-6893
Phone (678) 769-4088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY003119GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theramed Health, LLC Clinical CurrentSince Sep 22, 2014 Accepting new patients

Locations

3950 Cobb Pkwy NW
Ste 401
Acworth, GA 30101
Phone (404) 857-9575

3250 Quick Water Lndg NW
Kennesaw, GA 30144
Phone (404) 857-9575

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1942494711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 HILLCREST RD NW STE 400",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476893",
            "telephone_number": "678-769-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HILLCREST RD NW STE 400",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476893",
            "telephone_number": "678-769-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 W Hill St Ste 204D",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300304368",
            "country_code": "US",
            "telephone_number": "678-769-4088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RINEY",
        "first_name": "CHARLES",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "RINEY",
            "middle_name": "TIMOTHY",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lilburn, GA

Sources for this page

Verify at the official NPI Registry.