Organization Active NPI

Riverview Medical Group PLLC

  • Family Medicine Physician
  • Brush, CO
National Provider Identifier
1497204465
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60687206 Issued in WA
Legal business name
RIVERVIEW MEDICAL GROUP PLLC
Practice address
2400 Edison St
Brush, CO 80723-1640
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
Sep 30, 2016
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Michelle Pappy, M.D.NPI 1235490871
Title
Sole Owner
Phone
(405) 543-4758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR0057542 CO
Family Medicine Physician 207Q00000X MD60687206 WA Primary

Addresses

Primary practice location

2400 Edison St
Brush, CO 80723-1640

Mailing address

2660 Crimson Canyon Dr Ste 130
Las Vegas, NV 89128-0846
Phone (702) 453-3799

Other practice location 1

1690 Meade St
Denver, CO 80204-1552
Phone (702) 453-3799

Other practice location 2

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (702) 453-3799

Other practice location 3

501 Airport Rd
Rifle, CO 81650-8510
Phone (702) 453-3799

Other practice location 4

1338 Phay Ave
Canon City, CO 81212-2311
Phone (702) 453-3799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181220000244 AZ Part B Supplier - Clinic/Group Practice 1951689165 Receives reassigned benefits from 1 practitioner
Practice locations: Wickenburg, AZ

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": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1497204465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 CRIMSON CANYON DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280846",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807231640",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Meade St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802041552",
            "country_code": "US",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "WA",
            "postal_code": "994032829",
            "country_code": "US",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Rifle",
            "state": "CO",
            "postal_code": "816508510",
            "country_code": "US",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1338 Phay Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812122311",
            "country_code": "US",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERVIEW MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "PAPPY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "405-543-4758",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR0057542",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60687206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.