Riverside General Hospital

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

000460 Issued in TX

Legal business name

RIVERSIDE GENERAL HOSPITAL

Practice address

3204 Ennis Street
Houston, TX 77004-3213

Phone

(713) 526-2441

Fax

(713) 526-8754

NPI assigned

Apr 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Earnest Gibson III

Title

President

Phone

(713) 526-2441

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 450446

Legal name

RIVERSIDE GENERAL HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Apr 30, 2014

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Nov 28, 2013

Beds

98

Ownership / control type

Private (not for profit)

Facility address

3204 Ennis St
Houston, TX 77004

Locations

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1689639254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 ENNIS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770043213",
            "telephone_number": "713-526-2441",
            "fax_number": "713-526-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 ENNIS STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770043213",
            "telephone_number": "713-526-2441",
            "fax_number": "713-526-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "GIBSON III",
        "authorized_official_first_name": "EARNEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-526-2441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131040104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Rivers, MD
• Juanita Aracely Rivers
• Mareshia Rochelle Rivers
• Rhonda J Rivers
• Tabitha Rivers
• Riverside General Hospital Medical Clinic
• Riverside Pharmacy Dba Canal Pharmacy
• Riverside Regional EMS Inc
• Riverside Southeast Mental Health Clinic, Inc.
• Riverunbroken Trauma Counseling, PLLC

• General Acute Care Hospital in Houston, TX
• Providers in Houston, TX by specialty
• General Acute Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.