Riverfront Urgent Care Center LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

017268 Issued in LA

Legal business name

RIVERFRONT URGENT CARE CENTER LLC

Practice address

107 Front St
Ste 2138
Vidalia, LA 71373-2836

Phone

(318) 336-2219

Fax

(318) 336-6067

NPI assigned

Jul 5, 2016

Organization subpart

No

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

Authorized official

Name

John H Fairbanks, M.D.

Title

Owner

Phone

(318) 336-2212

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1275985012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 FRONT ST",
            "address_2": "STE 2138",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732836",
            "telephone_number": "318-336-2219",
            "fax_number": "318-336-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FRONT ST",
            "address_2": "STE 2138",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732836",
            "telephone_number": "318-336-2219",
            "fax_number": "318-336-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERFRONT URGENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-336-2212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "017268",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "LA",
            "license": "017268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Urgent Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.