NPIMap

Organization Active NPI

River City Nephrology PLLC

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1093450652
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RIVER CITY NEPHROLOGY PLLC
Practice address
2449 University Blvd W
Jacksonville, FL 32217-2037
Phone
(904) 730-1225
Fax
(904) 341-5457
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Rabie I Adam-Eldien, MDNPI 1104873355
Title
Owner
Phone
(727) 863-5418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2449 University Blvd W
Jacksonville, FL 32217-2037

Mailing address

2449 University Blvd W
Jacksonville, FL 32217-2037
Phone (904) 730-1225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220505001034 FL Part B Supplier - Clinic/Group Practice 4183011455 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

2449 University Blvd W
Jacksonville, FL 32217
Phone (904) 256-3330

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26160/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1093450652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172037",
            "telephone_number": "904-730-1225",
            "fax_number": "904-341-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172037",
            "telephone_number": "904-730-1225",
            "fax_number": "904-341-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY NEPHROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "ADAM-ELDIEN",
        "authorized_official_first_name": "RABIE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-863-5418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.

Verify at the official NPI Registry.