Riverside Orthopedic Clinic

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

M-10556 Issued in ID

Legal business name

RIVERSIDE ORTHOPEDIC CLINIC

Practice address

910 NW 16TH St
#205
Fruitland, ID 83619-2265

Phone

(208) 452-3111

Fax

(208) 452-3666

NPI assigned

Sep 15, 2015

Last updated

Sep 15, 2015By 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

Jennifer White

Title

Office Manager

Phone

(208) 452-3111

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1417326968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NW 16TH ST",
            "address_2": "#205",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192265",
            "telephone_number": "208-452-3111",
            "fax_number": "208-452-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NW 16TH ST",
            "address_2": "#205",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192265",
            "telephone_number": "208-452-3111",
            "fax_number": "208-452-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ORTHOPEDIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-452-3111"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-10864",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M-10556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Pulsipher, DPT
• Jeanette Hazel Marie Reiners, DNP, FNP
• Jeanna Rae Rendo, NP-C
• RH Counseling and Therapy LLC
• Sierra Marie Riley
• Tyler Robb, DDS
• George J Roth, PA-C
• Rxpad Medical
• Saint Alphonsus Medical Center- Ontario Inc (Saint Alphonsus Medical Group Fruitland Health Plaza)
• Kimberly Schultheiss, RPH

• Orthopaedic Surgery Physician in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Orthopaedic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.