Riverside Medical Diagnostic and Imaging, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

RIVERSIDE MEDICAL DIAGNOSTIC AND IMAGING, LLC

Practice address

2151 Riverside Ave
Jacksonville, FL 32204-4416

Phone

(904) 389-6707

Fax

(904) 389-6717

NPI assigned

Jul 14, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Corby Marshall

Title

Managing Partner

Phone

(912) 253-0375

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1336378165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044416",
            "telephone_number": "904-389-6707",
            "fax_number": "904-389-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044416",
            "telephone_number": "904-389-6707",
            "fax_number": "904-389-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL DIAGNOSTIC AND IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "CORBY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "912-253-0375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Riverside Operator LLC
• Riverside Park Surgicenter LLC
• Riverside Spine & Pain Physicians, LLC
• Riverside Spine & Pain Physicians, LLC
• Riverside Spine & Pain Physicians, LLC

• Magnetic Resonance Imaging (MRI) Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.