Organization Active NPI

Riverside Physician Services Inc

  • Family Medicine Physician
  • Smithfield, VA
National Provider Identifier
1184834871
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Practice address
1200 Benns Church Blvd
Smithfield, VA 23430-6063
Phone
(757) 674-9050
Fax
(757) 674-9099
NPI assigned
May 23, 2007
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Billie Jo Brown
Title
Credentialing Manager
Phone
(757) 316-5901

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

1200 Benns Church Blvd
Smithfield, VA 23430-6063

Mailing address

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

Other names 1

  • Riverside Primary Care Smithfield Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040207000400 VA Part B Supplier - Clinic/Group Practice 5092608448 Receives reassigned benefits from 1,191 practitioners
This NPI is an additional NPI on the enrollment

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
49D2331745Riverside Primary Care- Smithfield1200 Benns Church Blvd, Smithfield, VA 23430Certificate of waiverOct 7, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1184834871",
    "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": "1200 BENNS CHURCH BLVD",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234306063",
            "telephone_number": "757-674-9050",
            "fax_number": "757-674-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOCIATES",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BILLIE JO",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "757-316-5901"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Primary Care Smithfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.