Riverside ER LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

RIVERSIDE ER LLC

Practice address

1860 S Seguin Ave
New Braunfels, TX 78130-3914

Phone

(830) 468-5600

Fax

(830) 468-5743

NPI assigned

Jan 18, 2018

Last updated

Jan 18, 2018By 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

Adaeze Nwosu, MD

Title

Partner

Phone

(830) 468-5600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164930525. Details of each certification follow.

• CCN 670241 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 670241

Legal name

RIVERSIDE ER LLC

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Apr 24, 2020

Last certification

Apr 24, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

1860 S. Seguin Ave, Suite 400
New Braunfels, TX 78130

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.

• Nwando Onaedo Okafor, M.D

  • Emergency Medicine Physician
  • Corpus Christi, TX
  • NPI 1932414778
  NPD

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1164930525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310897",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781310897",
            "telephone_number": "830-468-5600",
            "fax_number": "830-468-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 S SEGUIN AVE",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781303914",
            "telephone_number": "830-468-5600",
            "fax_number": "830-468-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "NWOSU",
        "authorized_official_first_name": "ADAEZE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "830-468-5600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Rivera, COTA
• Sitlaly Anahi Rivera
• Riverbend Counseling PLLC
• Rivercrest Family Dental, P.a.
• Riverside Counseling Center, PLLC (Ellie Mental Health)
• Elizabeth Aadland Roark, FNP-BC
• William Chad Roasa, PA-C
• Julie Eileen Roat, FNP-C
• Claire Roberts
• Denise Roberts

• Emergency Care Clinic/Center in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.