NPIMap

Organization Active NPI

Riverside Hospital, Inc

Doing business as Riverside Cancer Infusion Center-Suffolk

  • General Acute Care Hospital
  • Suffolk, VA
National Provider Identifier
1033515101
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H1887 Issued in VA
Legal business name
RIVERSIDE HOSPITAL, INC
Doing business as
Riverside Cancer Infusion Center-Suffolk
Practice address
5839 Harbour View Blvd Ste 100
Suffolk, VA 23435-3797
Phone
(757) 397-4200
NPI assigned
Nov 17, 2014
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Mr. Walter W Austin Jr.
Title
Cfo
Phone
(757) 875-7545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1887 VA Primary

Addresses

Primary practice location

5839 Harbour View Blvd Ste 100
Suffolk, VA 23435-3797

Mailing address

608 Denbigh Boulevard
Suite 800
Newport News, VA 23608-4487
Phone (757) 875-7545

Other identifiers 1

IdentifierTypeStateIssuer
4900529MedicaidVA

Other names 1

  • Riverside Cancer Infusion Center-Suffolk Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Robert N Mucciola MD18 organizations share this tax ID, including this one
Part of
Robert N Mucciola MD

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

5835 Harbour View Blvd
Ste C1
Suffolk, VA 23435

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1033515101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BOULEVARD",
            "address_2": "SUITE 800",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084487",
            "telephone_number": "757-875-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 HARBOUR VIEW BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-397-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HOSPITAL, INC",
        "enumeration_date": "2014-11-17",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-875-7545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "H1887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4900529",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Cancer Infusion Center-Suffolk",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverside Cancer Infusion Center-Suffolk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.