NPIMap

Organization Active NPI

Riverside Physician Services Inc

  • Otolaryngology Physician
  • Gloucester, VA
National Provider Identifier
1114170552
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Practice address
7552 Hospital Dr Ste 302
Gloucester, VA 23061-4178
Phone
(804) 693-6720
Fax
(804) 693-9875
NPI assigned
Oct 29, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE PHYSICIAN SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Braden Miller, MD
Title
Cfo
Phone
(757) 316-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X VA Primary

Addresses

Primary practice location

7552 Hospital Dr Ste 302
Gloucester, VA 23061-4178

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318
Phone (757) 594-4006

Other practice location 1

7570 Hospital Drive
Bldg. B Suite 105
Gloucester, VA 23061
Phone (804) 693-3478

National Provider Directory

National Provider Directory
Tax ID family
Riverside OB-GYN88 organizations share this tax ID, including this one
Part of
Riverside OB-GYN

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

7570 Hospital Dr
#B
Gloucester, VA 23061
Phone (804) 693-3478

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1114170552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-594-4006",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 HOSPITAL DR STE 302",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614178",
            "telephone_number": "804-693-6720",
            "fax_number": "804-693-9875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7570 Hospital Drive",
            "address_2": "Bldg. B Suite 105",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "VA",
            "postal_code": "23061",
            "country_code": "US",
            "telephone_number": "804-693-3478",
            "fax_number": "804-693-3507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "enumeration_date": "2008-10-29",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-316-5900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.