SHANNON RILEY MD
NPI 1962820779
Pediatrics in Memphis, TN

Q: What is Shannon Riley's NPI number?

The NPI number for Shannon Riley is 1962820779. It was assigned to this individual provider in the NPPES registry on March 31, 2014.

Q: What is Shannon Riley's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Riley was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 31, 2014PECOS Enrolled

848 ADAMS AVE, MEMPHIS, TN 38103(901) 287-6112 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2021, Sep 15, 2018 (2 updates tracked since 2018).

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About Shannon Riley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON RILEY MD (NPI 1962820779) is an individual pediatrics provider in Memphis, Tennessee, licensed in Tennessee (56154) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1962820779

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameSHANNON RILEYCredential: MD

Location Address848 ADAMS AVEMemphis, TN 38103-2816

Mailing Address2040 W Charleston Blvd Ste 402Las Vegas, NV 89102-2250

Phone(901) 287-6112

Sole ProprietorNo

Enumeration DateMarch 31, 2014

Last NPPES UpdateDecember 17, 20212 updates tracked since enumeration

✔ NPI 1962820779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TN · 56154

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 56154 (TN)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

848 ADAMS AVE, Memphis, TN 38103

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Secondary Practice Location 1

Location 12040 W Charleston Blvd Ste 402Las Vegas, NV 89102-2250 · Phone (702) 671-2236

Other Identifiers 1

MedicaidPENDINGTN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Riley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Riley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

1,742 mi

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GLENN T WETZEL MD

Pediatrics (Pediatric Cardiology)