Rivers Edge Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101054576 Issued in VA

Legal business name

RIVERS EDGE FAMILY MEDICINE

Practice address

330 Winding River Lane
Charlottesville, VA 22911-3551

Phone

(434) 295-3705

Fax

(434) 295-3705

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Ann Marie Klecan, M.D.

Title

Doctor

Phone

(434) 295-3705

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1013060359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WINDING RIVER LANE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113551",
            "telephone_number": "434-295-3705",
            "fax_number": "434-295-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WINDING RIVER LANE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113551",
            "telephone_number": "434-295-3705",
            "fax_number": "434-295-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERS EDGE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "KLECAN",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "434-295-3705",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101054576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "187671",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "408456",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010259231",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Michael Rivera
• Riverbend Integrative Trauma Treatment
• Riverdale Homes, Inc
• Riverhaven Community Birth Center
• Jamie Molloy Rivero, MS CCC-SLP
• Riverside Pharmacy Services Charlottesville
• Justin Rizer, MD
• Tanvir Rizvi, MD
• Carolyn Rizza, LPC
• Joshua Roach

• Family Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.