Organization Active NPI

Dr G MD, LLC

Doing business as Rivertown Family Medicine

  • Primary Care Clinic/Center
  • Conway, SC
National Provider Identifier
1629881479
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DR G MD, LLC
Doing business as
Rivertown Family Medicine
Practice address
1210 Main St
Conway, SC 29526-3633
Phone
(843) 488-1700
Fax
(843) 488-4301
NPI assigned
Jan 27, 2025
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Dr. Brittany Zumpetta Gusic, MDNPI 1679836597
Title
Owner
Phone
(304) 820-6542

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 1

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

Addresses

Primary practice location

1210 Main St
Conway, SC 29526-3633

Mailing address

1210 Main St
Conway, SC 29526-3633
Phone (843) 488-1700

Other names 1

  • Rivertown Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422003250 SC Part B Supplier - Clinic/Group Practice 0648795690 Receives reassigned benefits from 1 practitioner
Practice locations: Conway, SC

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": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1629881479",
    "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": "843-488-1700",
            "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": "843-488-1700",
            "fax_number": "843-488-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR G MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "GUSIC",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "ZUMPETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-820-6542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivertown Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 27, 2025; 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.