NPIMap

Organization Active NPI

Rivertown Wellness Center, LLC

  • Primary Care Clinic/Center
  • Conway, SC
National Provider Identifier
1447637327
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0285 Issued in SC
Legal business name
RIVERTOWN WELLNESS CENTER, LLC
Practice address
1210 Main St
Conway, SC 29526-3633
Phone
(843) 488-4300
Fax
(843) 488-4301
NPI assigned
Apr 30, 2015
Last updated
Apr 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Mrs. Siena Shields Alford, DONPI 1881648319
Title
Physician
Phone
(843) 488-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0285 SC Primary

Addresses

Primary practice location

1210 Main St
Conway, SC 29526-3633

Mailing address

1210 Main St
Conway, SC 29526-3633
Phone (843) 488-4300

Other identifiers 3

IdentifierTypeStateIssuer
E325848035OtherSCMEDICARE ID
42D0940858OtherCLIA
TL0665MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1447637327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263633",
            "telephone_number": "843-488-4300",
            "fax_number": "843-488-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263633",
            "telephone_number": "843-488-4300",
            "fax_number": "843-488-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTOWN WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "ALFORD",
        "authorized_official_first_name": "SIENA",
        "authorized_official_middle_name": "SHIELDS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-488-4300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "0285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "E325848035",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "42D0940858",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL0665",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.