Organization Active NPI

Ria Medical, LLC

  • Internal Medicine Physician
  • Wentzville, MO
National Provider Identifier
1174615025
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007036351 Issued in MO
Legal business name
RIA MEDICAL, LLC
Practice address
105 Creekside Office Dr.
Wentzville, MO 63385
Phone
(636) 639-6262
Fax
(636) 639-1375
NPI assigned
Sep 29, 2006
Last updated
Oct 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Navin Choudhary, M.D.NPI 1104913896
Title
Owner
Phone
(636) 639-6262

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Internal Medicine Physician 207R00000X 2011002808 MO
Internal Medicine Physician 207R00000X 2007036351 MO Primary

Addresses

Primary practice location

105 Creekside Office Dr.
Wentzville, MO 63385

Mailing address

105 Creekside Office Dr.
Wentzville, MO 63385
Phone (636) 639-6262

Other identifiers 3

IdentifierTypeStateIssuer
1437455441MedicaidMO
204476907MedicaidMO
204488805MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041228000701 MO Part B Supplier - Clinic/Group Practice 6608834395 Receives reassigned benefits from 10 practitioners
Practice locations: Wright City, MO; Wentzville, MT; Wentzville, MO; O'Fallon, MO; Warrenton, MO; St Charles, MO; Saint Peters, MO; Saint Charles, MO…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1035636Ria Medical LLC105 Creekside Office Drive, Wentzville, MO 63385Certificate of waiverJan 6, 2027

National Provider Directory

National Provider Directory

Locations

2002 Boardwalk Place Dr
O Fallon, MO 63368
Phone (386) 688-7988

1000 Landing Cir
Saint Charles, MO 63304
Phone (636) 669-0799

125 Klondike Xing
Saint Peters, MO 63376
Phone (636) 284-2597

1000 Warrenton Shoppes
Warrenton, MO 63383

1000 Warrenton Shoppes
Ste 31
Warrenton, MO 63383
Phone (636) 639-6262

118 S East St
Warrenton, MO 63383
Phone (636) 456-3340

600 Medical Dr
Ste 106
Wentzville, MO 63385
Phone (636) 327-1250

600 Medical Dr
Ste 216
Wentzville, MO 63385
Phone (636) 332-8482

65 Highway AA
Wright City, MO 63390
Phone (636) 456-3340

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24426/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1174615025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CREEKSIDE OFFICE DR.",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-639-6262",
            "fax_number": "636-639-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CREEKSIDE OFFICE DR.",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-639-6262",
            "fax_number": "636-639-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "CHOUDHARY",
        "authorized_official_first_name": "NAVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-639-6262",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2011002808",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007036351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437455441",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204476907",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204488805",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.