Individual provider Active NPI

Amanda Jenkins Riley, NP-C

  • Family Nurse Practitioner
  • Butler, GA
National Provider Identifier
1992126775
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN164620 Issued in GA
Practice address
80 W Main St
Butler, GA 31006-5156
Phone
(478) 862-5453
Fax
(478) 862-5454
NPI assigned
Dec 23, 2013
Last updated
May 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN164620 GA Primary

Addresses

Primary practice location

80 W Main St
Butler, GA 31006-5156

Mailing address

80 W Main St
Butler, GA 31006-5156
Phone (478) 862-5453

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141118001144 GA Practitioner - Nurse Practitioner 9739318197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas C Jones, M.D., P.C.Group PAC ID 2769558030, 13 clinicians

Practice addresses (Care Compare)

265 Sheraton Blvd
Macon, GA 31210-1359
Phone (478) 746-8626

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN164620GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Feb 10, 2015 Accepting new patients
Thomas C Jones, M.D., P.C. CurrentSince Aug 10, 2021 Accepting new patients
Careconnect Health, Inc. CurrentSince Feb 10, 2015 Accepting new patients

Locations

80 W Main St
Butler, GA 31006
Phone (478) 862-3879

265 Sheraton Blvd
Macon, GA 31210
Phone (478) 746-8626

265 Sheraton Blvd
Ste 100
Macon, GA 31210

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1992126775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "BUTLER",
            "state": "GA",
            "postal_code": "310065156",
            "telephone_number": "478-862-5453",
            "fax_number": "478-862-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "BUTLER",
            "state": "GA",
            "postal_code": "310065156",
            "telephone_number": "478-862-5453",
            "fax_number": "478-862-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "AMANDA",
        "middle_name": "JENKINS",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN164620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, GA

Sources for this page

Verify at the official NPI Registry.