River City Orthotics and Prosthetics, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

209-10982 Issued in TX

Legal business name

RIVER CITY ORTHOTICS AND PROSTHETICS, LLC

Practice address

16607 Blanco Rd
Suite 303
San Antonio, TX 78232-1940

Phone

(210) 485-1844

Fax

(210) 439-9504

NPI assigned

Jan 14, 2010

Organization subpart

No

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

Authorized official

Name

Mr. David Berardelli

Title

Owner

Phone

(210) 485-1844

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1215268248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16607 BLANCO ROAD",
            "address_2": "SUITE 303",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321940",
            "telephone_number": "210-485-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16607 BLANCO RD",
            "address_2": "SUITE 303",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321940",
            "telephone_number": "210-485-1844",
            "fax_number": "210-439-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY ORTHOTICS AND PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "BERARDELLI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-485-1844",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "209-10982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "209-10982",
            "identifier": "1659601946",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C21287",
            "identifier": "1659601946",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River City Medical Clinic PA
• River City Neurology PA
• River City Nurse Management LLC
• River City Observation Services PLLC
• River City Oral and Maxillofacial Surgery, PLLC
• River City Pain Management, PLLC
• River City Pediatric Emergency Physicians, PLLC
• River City Rehabiliation Center, Inc.
• River Medical Pharmacy, LLC
• Helena Rivera Bali, CFY-SLP

• Prosthetic/Orthotic Supplier in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.