NPIMap

Organization Active NPI

Riverside Retirement Service, Inc

  • PACE Provider Organization
  • Petersburg, VA
National Provider Identifier
1447537758
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
RIVERSIDE RETIREMENT SERVICE, INC
Practice address
319 Brown St
Petersburg, VA 23803-4247
Phone
(757) 369-5137
NPI assigned
Nov 15, 2011
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Craig Connors
Title
VP Community Based Services
Phone
(757) 875-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

319 Brown St
Petersburg, VA 23803-4247

Mailing address

1020 Old Denbigh Blvd
Newport News, VA 23602-2017
Phone (757) 875-2050

Other identifiers 1

IdentifierTypeStateIssuer
H8655OtherMEDICARE CONTRACT NUMBER

Other names 1

  • Riverside PACE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riverside Retirement Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1447537758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 OLD DENBIGH BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236022017",
            "telephone_number": "757-875-2050",
            "fax_number": "757-875-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 BROWN ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034247",
            "telephone_number": "757-369-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE RETIREMENT SERVICE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOCIATION, INC",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "CONNORS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "VP COMMUNITY BASED SERVICES",
        "authorized_official_telephone_number": "757-875-2050"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CONTRACT NUMBER",
            "identifier": "H8655",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.