Individual provider Active NPI

Riley Kay Maxwell

  • Occupational Therapist
  • Council Bluffs, IA
National Provider Identifier
1942783451
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
093652 Issued in IA
Practice address
3000 Risen Son Blvd
Council Bluffs, IA 51503-1911
Phone
(712) 366-9655
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 093652 IA Primary

Addresses

Primary practice location

3000 Risen Son Blvd
Council Bluffs, IA 51503-1911

Mailing address

501 S 67TH St
Omaha, NE 68106-1101
Phone (402) 250-6405

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

LicenseStateTypeSpecialty
2262NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Aug 9, 2024 Accepting new patients
Pando Geriatric Counseling, PC Past Accepting new patients

Locations

6991 S 178th Plz
Omaha, NE 68136
Phone (402) 819-0669

4801 N 52nd St
Omaha, NE 68104
Phone (402) 557-6860

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1942783451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 67TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061101",
            "telephone_number": "402-250-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 RISEN SON BLVD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031911",
            "telephone_number": "712-366-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "RILEY",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "093652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.