Riverside Physician Services Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

RIVERSIDE PHYSICIAN SERVICES INC

Practice address

7554 Hospital Dr
Suite 303
Gloucester, VA 23061-4178

Phone

(757) 534-5340

Fax

(757) 594-3456

NPI assigned

Sep 6, 2007

Last updated

Sep 7, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

RIVERSIDE HEALTHCARE ASSOCAs reported in NPPES

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

Authorized official

Name

Braden Miller

Title

Cfo

Phone

(757) 316-5960

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1538354279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5960",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7554 HOSPITAL DR",
            "address_2": "SUITE 303",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614178",
            "telephone_number": "757-534-5340",
            "fax_number": "757-594-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOC",
        "enumeration_date": "2007-09-06",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-316-5960"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Physician Services Inc (Riverside Radiation Oncology Specialists)
• Riverside Physician Services Inc (Riverside Walter Reed Hospitalists)
• Riverside Physician Services Inc (Riverside Urology Specialists)
• Riverside Physician Services Inc (Women's Healthcare)
• Riverside Physician Services Inc (Hampton Roads Eye Associates-Gloucester)
• Riverside Physician Services Inc (Riverside Renal Specialists)
• Riverside Physician Services Inc (Riverside Gloucester Palliative Care and Hospice Specialists)
• Riverside Physician Services Inc (Riverside Pulmonary and Sleep Specialists Gloucester)
• Riverside Physician Services Inc (Internal Medicince Associates of Gloucester)
• Riverside Physician Services Inc (Gloucester Surgery)

• Vascular Surgery Physician in Gloucester, VA
• Providers in Gloucester, VA by specialty
• Vascular Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.