Organization Active NPI

Riverside Family Medicine, P.C.

  • Family Medicine Physician
  • Northport, AL
National Provider Identifier
1669445433
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVERSIDE FAMILY MEDICINE, P.C.
Practice address
4520 Watermelon Rd
Northport, AL 35473-5246
Phone
(205) 752-7443
Fax
(205) 556-8868
NPI assigned
Feb 10, 2006
Last updated
Dec 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Authorized official

Name
Sonya Chapin
Title
Office Manager
Phone
(205) 752-7445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4520 Watermelon Rd
Northport, AL 35473-5246

Mailing address

4520 Watermelon Rd
Northport, AL 35473-5246
Phone (205) 752-7443

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevin.katona@rivfamed.direct.medconnect-inc.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051026000677 AL Part B Supplier - Clinic/Group Practice 7416974712 Receives reassigned benefits from 2 practitioners
Practice locations: Northport, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0985229Riverside Family Medicine PC4520 Watermelon Road, Northport, AL 35473Certificate of waiverJun 28, 2027

National Provider Directory

National Provider Directory

Locations

4520 Watermelon Rd
Northport, AL 35473
Phone (205) 556-5521

535 Jack Warner Pkwy NE
Ste F1
Tuscaloosa, AL 35404
Phone (205) 556-5521

Practitioners & affiliated clinicians

Practitioners 3

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": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1669445433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735246",
            "telephone_number": "205-752-7443",
            "fax_number": "205-556-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735246",
            "telephone_number": "205-752-7443",
            "fax_number": "205-556-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "CHAPIN",
        "authorized_official_first_name": "SONYA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-752-7445"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.katona@rivfamed.direct.medconnect-inc.com",
            "affiliation": "N",
            "endpointDescription": "direct encrypted messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4520 Watermelon Rd",
            "city": "Northport",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354735246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.