Active NPI
Riverside Family Medical
- Medical Physician Assistant
- Lawrenceville, GA
National Provider Identifier
1306980263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 002087
- Legal business name
- RIVERSIDE FAMILY MEDICAL
- Practice address
- 1960 Riverside Pkwy Ste 106
Lawrenceville, GA 30043-5945 - Phone
- (678) 407-2222
- Fax
- (678) 407-2266
- NPI assigned
- Feb 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dave W. George, P.A.
- Title
- Owner
- Phone
- (678) 407-2222
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 034091 | GA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 049316 | GA | |
| Medical Physician Assistant | 363AM0700X | 002087 | GA | Primary |
Addresses
Primary practice location
1960 Riverside Pkwy Ste 106
Lawrenceville, GA 30043-5945
Mailing address
1960 Riverside Pkwy Ste 106
Lawrenceville, GA 30043-5945
Phone (678) 407-2222
Other names 1
- RIVERSIDE FAMILY MEDICAL
National Provider Directory
National Provider DirectoryLocations
1980 Riverside Pkwy
Ste 102
Lawrenceville, GA 30043
Phone (678) 407-2222
Interoperability endpoints
- https://api.platform.athenahealth.com/14978/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Medicine Physician
- Lawrenceville, GA
- NPI 1992851604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1306980263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 RIVERSIDE PKWY STE 106",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435945",
"telephone_number": "678-407-2222",
"fax_number": "678-407-2266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 RIVERSIDE PKWY STE 106",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435945",
"telephone_number": "678-407-2222",
"fax_number": "678-407-2266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERSIDE FAMILY MEDICAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-16",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "GEORGE",
"authorized_official_first_name": "DAVE",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "678-407-2222",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "P.A."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "GA",
"license": "034091",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "GA",
"license": "049316",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "002087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "RIVERSIDE FAMILY MEDICAL",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.