Active NPI
Kimberly Riley
- Pediatrics Physician
- Charlotte, NC
National Provider Identifier
1992729776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9501563
- Practice address
- 3030 Randolph Rd
Suite 102
Charlotte, NC 28211-1368 - Phone
- (704) 512-4475
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9501563 | NC | Primary |
Addresses
Primary practice location
3030 Randolph Rd
Suite 102
Charlotte, NC 28211-1368
Mailing address
3030 Randolph Rd
Charlotte, NC 28211-1368
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Pediatrics | Pediatrics | Past | Accepting new patients |
| Carolinas Physicians Network Inc | Past | Accepting new patients |
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.
-
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1740848100
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1073541124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544745600000",
"number": "1992729776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 RANDOLPH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 RANDOLPH RD",
"address_2": "SUITE 102",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111368",
"telephone_number": "704-512-4475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2018-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "9501563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.