NPIMap

Organization Active NPI

Riverway Medical Group a Medical Corporation

  • Family Medicine Physician
  • Visalia, CA
National Provider Identifier
1265046395
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVERWAY MEDICAL GROUP A MEDICAL CORPORATION
Practice address
1827 S Court St Ste B
Visalia, CA 93277-5469
Phone
(559) 260-6509
NPI assigned
Sep 5, 2020
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Jared Williams, NP
Title
Owner
Phone
(559) 372-7390

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1827 S Court St Ste B
Visalia, CA 93277-5469

Mailing address

PO Box 1511
Visalia, CA 93279-1511

Other practice location 1

1827 S Court St Ste A
Visalia, CA 93277-5469
Phone (559) 260-6509

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201207001302 CA Part B Supplier - Clinic/Group Practice 6204248701 Receives reassigned benefits from 10 practitioners
Practice locations: Visalia, CA

National Provider Directory

National Provider Directory

Locations

1827 S Court St
Ste A
Visalia, CA 93277
Phone (559) 372-7390

1827 S Court St
Ste B
Visalia, CA 93277
Phone (559) 260-6509

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1265046395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1511",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932791511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 S COURT ST STE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775469",
            "telephone_number": "559-260-6509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1827 S Court St Ste A",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932775469",
            "country_code": "US",
            "telephone_number": "559-260-6509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERWAY MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-05",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-372-7390",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.