Riverview Services LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

RIVERVIEW SERVICES LLC

Doing business as

Riverview Health

Practice address

417 River Dr
Irvine, KY 40336-1272

Phone

(606) 723-0695

Fax

(606) 723-0043

NPI assigned

Nov 5, 2021

Last updated

Nov 5, 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

Pamela JonesNPI 1205807849

Title

Owner

Phone

(606) 723-0695

Specialties & licenses 2

Addresses

Other names 1

• RIVERVIEW HEALTH Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386309185. Details of each certification follow.

• CCN B03879 Rural health clinic · Active · Details

Rural health clinic certification: CCN B03879

Legal name

RIVERVIEW SERVICES, LLC

Doing business as

RIVERVIEW HEALTH

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 28, 2022

Last certification

Mar 28, 2022

Ownership / control type

1A

Organization structure

LLCProprietary

Incorporated

May 21, 2021 in KY

Enrollment address

417 River Dr
Irvine, KY 40336-1272

Other NPIs with the same Medicare PAC ID 1

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

• Riverview Services, LLC

  • Family Medicine Physician
  • Irvine, KY
  • NPI 1275104481

  3577960772

  Same PAC ID

Tax ID family

Riverview Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Riverview Services, LLC

  • Family Medicine Physician
  • Irvine, KY
  • NPI 1275104481
  NPD tax ID

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Pamela Jones, APRN

  • Family Nurse Practitioner
  • Irvine, KY
  • NPI 1205807849

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela Jones, APRN

  • Family Nurse Practitioner
  • Irvine, KY
  • NPI 1205807849
  NPD Authorized official

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1386309185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 RIVER DR",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361272",
            "telephone_number": "606-723-0695",
            "fax_number": "606-723-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 RIVER DR",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361272",
            "telephone_number": "606-723-0695",
            "fax_number": "606-723-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERVIEW SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-723-0695"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERVIEW HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Respiratory Express Inc
• Kristen Reynolds, OTR/L
• Shawn Christian Rice, D.O.
• River Drive Pharmacy LLC
• Riverview Clinic PSC
• Riverview Services, LLC
• Kendra B Robertson, PA-C
• Mark Rukavina, MD
• Justin Andrew Sandlin, PHARM. D
• Shawn Schaeffer, LCSW, MSW

• Rural Health Clinic/Center in Irvine, KY
• Providers in Irvine, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.