Active NPI
Arthritis Center of Riverside Medical Corporation
- Rheumatology Physician
- Riverside, CA
National Provider Identifier
1013076850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- A35128
- Legal business name
- ARTHRITIS CENTER OF RIVERSIDE MEDICAL CORPORATION
- Practice address
- 11725 Slate Ave
Suite 100
Riverside, CA 92505-7100 - Phone
- (951) 352-1700
- Fax
- (951) 352-9110
- NPI assigned
- Dec 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Jessica Henderson
- Title
- Billing Manager
- Phone
- (951) 352-1700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | A35128 | CA | Primary |
Addresses
Primary practice location
11725 Slate Ave
Suite 100
Riverside, CA 92505-7100
Mailing address
11725 Slate Ave
Suite 100
Riverside, CA 92505-7100
Phone (951) 352-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05D0575313 | Other | CA | CLIA # ARTHRITIS CENTER |
Other names 1
- Arthritis Center of Riverside
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
11725 Slate Ave
Ste 200
Riverside, CA 92505
4000 14th St
Ste 511
Riverside, CA 92501
Phone (909) 788-0850
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Rheumatology Physician
- Corona, CA
- NPI 1235278250
-
- Rheumatology Physician
- Riverside, CA
- NPI 1528128535
-
- Medical Physician Assistant
- Riverside, CA
- NPI 1821493230
-
- Physician Assistant
- Colton, CA
- NPI 1598708661
-
- Physician Assistant
- Riverside, CA
- NPI 1790535862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1444694400000",
"number": "1013076850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11725 SLATE AVE",
"address_2": "SUITE 100",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925057100",
"telephone_number": "951-352-1700",
"fax_number": "951-352-9110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11725 SLATE AVE",
"address_2": "SUITE 100",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925057100",
"telephone_number": "951-352-1700",
"fax_number": "951-352-9110"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARTHRITIS CENTER OF RIVERSIDE MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-07",
"last_updated": "2015-10-13",
"status": "A",
"authorized_official_last_name": "HENDERSON",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "951-352-1700",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "A35128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA # ARTHRITIS CENTER",
"identifier": "05D0575313",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Arthritis Center of Riverside",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.