River Horse Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RIVER HORSE MEDICAL CLINIC

Doing business as

River Horse Medical Clinic, Pllc

Practice address

222 Southway Ave Ste C
Lewiston, ID 83501-2703

Phone

(208) 792-1011

Fax

(208) 616-1453

NPI assigned

Sep 17, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Grinage, PA-C

Title

Owner/Ceo

Phone

(208) 792-1011

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• River Horse Medical Clinic, Pllc Doing business as

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1144057852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 225",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835010225",
            "telephone_number": "208-792-1011",
            "fax_number": "208-616-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SOUTHWAY AVE STE C",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012703",
            "telephone_number": "208-792-1011",
            "fax_number": "208-616-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER HORSE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "GRINAGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "208-792-1011",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1396151395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Horse Medical Clinic, Pllc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River Horse Medical Clinic, Pllc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John T Rietz, OD
• Jason Riggle, LMT
• Anita Ringering, NP
• Zachary S Ripley, D.O.
• Jason Scott Ritter
• Riverplace Counseling & Wellness
• Riverplace Counseling & Wellness
• Riverside Recovery LLC
• Robert J Lotstein
• Allison Roberts, OTR/L

• Primary Care Clinic/Center in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Primary Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.