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NPI Code Detail

MEDICARE: MS. EVELYN M RIES

MEDICARE: MS. EVELYN M RIES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantNC 1958NC
2225XP0200XPediatric Occupational TherapistNC 1958NC

General Provider Information

NPI Number : 1770786519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EVELYN M RIES
Provider Business Mailing Address
First Line : 4505 SHATTALON DRIVE
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27106
Country : US
Telephone Number : 336-924-9861
Fax Number :
Provider Business Practice Location Address
First Line : 4505 SHATTALON DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-2001
Country : US
Telephone Number : 336-924-9309
Fax Number : 336-924-0388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2007
Last Update Date : 09/11/2025

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