Riverside Physician Services Inc

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

RIVERSIDE PHYSICIAN SERVICES INC

Practice address

5231 John Tyler Hwy
Williamsburg, VA 23185-2553

Phone

(757) 220-8300

Fax

(757) 565-5338

NPI assigned

Aug 17, 2006

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) 316-3960

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Rector & Visitors of the University of Virginia

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Staunton, VA
  • NPI 1407212954

  Member Of

  NPD member

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1639282957",
    "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": "757-316-3960",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5231 JOHN TYLER HWY",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852553",
            "telephone_number": "757-220-8300",
            "fax_number": "757-565-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOC",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-316-3960"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc

• Emergency Medicine Physician in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.