NPIMap

Organization Active NPI

Riverside Physician Services Inc

  • Nephrology Physician
  • Gloucester, VA
National Provider Identifier
1669821856
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Doing business as
RIVERSIDE RENAL SPECIALISTS
Practice address
7552 Hospital Dr
Suite 302
Gloucester, VA 23061-4178
Phone
(804) 693-9062
Fax
(804) 694-0597
NPI assigned
Jun 8, 2016
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

7552 Hospital Dr
Suite 302
Gloucester, VA 23061-4178

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318
Phone (757) 316-5960

Other names 1

  • RIVERSIDE RENAL SPECIALISTS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
RPS Ta Rvrsde Tpphnck GRP88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1669821856",
    "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": "7552 HOSPITAL DR",
            "address_2": "SUITE 302",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614178",
            "telephone_number": "804-693-9062",
            "fax_number": "804-694-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOC",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "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": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERSIDE RENAL SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.