Active NPI
Rosalyn A Riley
- In Home Supportive Care Agency
- Jacksonville, FL
National Provider Identifier
1962122598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 404256
- Practice address
- 9273 Canary Ivy LN
Jacksonville, FL 32219-6001 - Phone
- (904) 559-6959
- Fax
- (904) 467-3848
- NPI assigned
- Sep 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 404256 | FL | Primary |
Addresses
Primary practice location
9273 Canary Ivy LN
Jacksonville, FL 32219-6001
Mailing address
9273 Canary Ivy LN
Jacksonville, FL 32219-6001
Phone (904) 559-6959
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 404256 | FL | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1962122598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9273 CANARY IVY LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322196001",
"telephone_number": "904-559-6959",
"fax_number": "904-467-3848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9273 CANARY IVY LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322196001",
"telephone_number": "904-559-6959",
"fax_number": "904-467-3848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "ROSALYN",
"middle_name": "A",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-01",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "FL",
"license": "404256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.