Riverside Medical Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

RIVERSIDE MEDICAL INC

Practice address

77 Crye Leike Dr
Fort Oglethorpe, GA 30742-4055

Phone

(762) 257-2100

Fax

(762) 320-5366

NPI assigned

Apr 9, 2021

Last updated

Apr 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory J Crawford

Title

Ceo

Phone

(859) 441-8876

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Riverside Medical Inc

  dba Quipt Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1770250342

  3072633296

  Same PAC ID
• Riverside Medical Inc

  dba Quipt Home Medical

  • Oxygen Equipment & Supplies (DME)
  • Savannah, TN
  • NPI 1962404129

  3072633296

  Same PAC ID

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

Medicare medical equipment & supply locations

Tax ID family

Riverside Medical Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Riverside Medical Inc

  dba Quipt Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1770250342
  NPD tax ID
• Riverside Medical Inc

  dba Quipt Home Medical

  • Oxygen Equipment & Supplies (DME)
  • Savannah, TN
  • NPI 1962404129
  NPD tax ID

Locations

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1346820800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 TOWN DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410769114",
            "telephone_number": "859-441-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CRYE LEIKE DR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424055",
            "telephone_number": "762-257-2100",
            "fax_number": "762-320-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-441-8876"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Dewayne Rector, MED, LPC
• Alisha Beth Reeves, PT, DPT
• Jenifer Lynn Reid, PT, DPT
• Renuven Health Partners of Georgia PC
• Robyn Elizabeth Richardson, LCSW
• Amy Roach, COTA
• Casey Suzanne Robinson-Bullock, PT, DPT
• Emily Diane Rodriguez, ABOC, NCLEC, LDO
• Heather Lawry Roesner, LPC
• Jonathan William Ronca, PHARMD

• Oxygen Equipment & Supplies (DME) in Fort Oglethorpe, GA
• Providers in Fort Oglethorpe, GA by specialty
• Oxygen Equipment & Supplies (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.