Organization Active NPI

Riverside Physician Services Inc

Doing business as Riverside GYN Specialists

  • Obstetrics & Gynecology Physician
  • Newport News, VA
National Provider Identifier
1679599120
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Doing business as
Riverside GYN Specialists
Practice address
608 Denbigh Blvd
Suite 701
Newport News, VA 23608-4413
Phone
(757) 874-8696
Fax
(757) 872-9904
NPI assigned
Jul 15, 2006
Organization subpart
Yes
Parent organization
RIVERSIDE PHYSICIAN SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
James Lenick
Title
Vice President
Phone
(757) 594-4006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

608 Denbigh Blvd
Suite 701
Newport News, VA 23608-4413

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318
Phone (757) 594-4006

Other names 1

  • Riverside GYN Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040207000400 VA Part B Supplier - Clinic/Group Practice 5092608448 Receives reassigned benefits from 1,191 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
RPS-Anesthesia Servicesgrp

Member of 1

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

Locations

606 Denbigh Blvd
Ste 701
Newport News, VA 23608
Phone (757) 875-7891

608 Denbigh Blvd
Ste 701
Newport News, VA 23608
Phone (757) 874-8696

Practitioners & affiliated clinicians

Practitioners 2

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1679599120",
    "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": "757-594-4006",
            "fax_number": "757-594-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BLVD",
            "address_2": "SUITE 701",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084413",
            "telephone_number": "757-874-8696",
            "fax_number": "757-872-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "enumeration_date": "2006-07-15",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "LENICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "757-594-4006"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside GYN Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.