NPIMap

Organization Active NPI

Rivertown Pediatrics, P.C.

  • Pediatrics Physician
  • Columbus, GA
National Provider Identifier
1346336203
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
RIVERTOWN PEDIATRICS, P.C.
Practice address
2416 Capstone CT
Columbus, GA 31909-2795
Phone
(706) 327-1281
Fax
(706) 576-9714
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Authorized official

Name
Debra Ledbetter, RN
Title
Practice Manager
Phone
(706) 327-1281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2416 Capstone CT
Columbus, GA 31909-2795

Mailing address

2416 Capstone CT
Columbus, GA 31909-2795
Phone (706) 327-1281

Other identifiers 7

IdentifierTypeStateIssuer
1528173036MedicaidGA
1558457549MedicaidGA
1780791657MedicaidGA
1275649758MedicaidGA
1073756169MedicaidGA
1235225541MedicaidGA
1861509812MedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0679957Rivertown Pediatrics PC2416 Capstone Court, Columbus, GA 31909Certificate of waiverFeb 15, 2028

National Provider Directory

National Provider Directory

Locations

2416 Capstone Ct
Columbus, GA 31909
Phone (706) 327-1281

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584662400000",
    "number": "1346336203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 CAPSTONE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092795",
            "telephone_number": "706-327-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 CAPSTONE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092795",
            "telephone_number": "706-327-1281",
            "fax_number": "706-576-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTOWN PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "706-327-1281",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528173036",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558457549",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780791657",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275649758",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073756169",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235225541",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861509812",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.