Riverbend Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

IN PROCESS Issued in OR

Legal business name

RIVERBEND AMBULATORY SURGERY CENTER LLC

Doing business as

Day Surgery at RiverBend

Practice address

3355 Riverbend Dr
Suite 110
Springfield, OR 97477-8800

Phone

(541) 852-4824

Fax

(541) 242-5115

NPI assigned

Jul 7, 2008

Last updated

Jul 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andy Kokkino, MD

Title

President of Board of Managers

Phone

(720) 320-6577

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Day Surgery at RiverBend Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Day Surgery at RiverbendCCN 38C0001089

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Duc Minh Vo, M.D.

  • Colon & Rectal Surgery Physician
  • Springfield, OR
  • NPI 1770564015
  NPD (past)

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1023271459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-852-4824",
            "fax_number": "541-242-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-852-4824",
            "fax_number": "541-242-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERBEND AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "KOKKINO",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD OF MANAGERS",
        "authorized_official_telephone_number": "720-320-6577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "IN PROCESS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1601",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Day Surgery at RiverBend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Binaya Rimal, M.D.
• Gregory Ripley, RPH
• Melody Kathleen Ristau, BSN, RN, CHPN
• Rebecca Rivera, FNP
• Rey Jose Rivera, M.D.
• Riverbend Dental
• Brittany Nicole Roach, RN
• Robert D Graham MD PC
• Robert J Charles MD PC
• Jason Davidson Roberts, FNP

• Ambulatory Surgical Clinic/Center in Springfield, OR
• Providers in Springfield, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.