Organization Active NPI

Riverside Family Medical

  • Medical Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1306980263
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002087 Issued in GA
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

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 034091 GA
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 049316 GA
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

1980 Riverside Pkwy
Ste 102
Lawrenceville, GA 30043
Phone (678) 407-2222

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.