Riverside Medical Associates, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TT007907 Issued in MI

Legal business name

RIVERSIDE MEDICAL ASSOCIATES, P.C.

Practice address

560 Osborn Blvd
Sault Sainte Marie, MI 49783-1961

Phone

(906) 632-1800

Fax

(906) 632-2199

NPI assigned

Nov 18, 2011

Organization subpart

No

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

Authorized official

Name

Kellie L Popour

Title

Office Manager

Phone

(906) 632-1800

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wesley C Fisher, PAC

  • Medical Physician Assistant
  • Sault Sainte Marie, MI
  • NPI 1922000124
  NPD (past)
• Kristina Lynne Masuga, M.D.

  • Family Medicine Physician
  • Sault Sainte Marie, MI
  • NPI 1033171871
  NPD (past)

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1649547654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831961",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831961",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "POPOUR",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "906-632-1800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "TT007907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alannah Renico
• Tera Anne Richards, OTRL
• Andrew Josiah Rife, P.A.
• Caitlin Elan Riley
• Riverside Medical Associates, P.C.
• Caleb Alan Robinson, PT
• Thomas George Robinson, DDS,MS
• Vasey Rocha
• Bethany Rodenroth, M.A. CCC-SLP
• Gretchen Roekle, LMT

• Family Medicine Physician in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.