NPIMap

Organization Active NPI

Riverside Spine & Physical Medicine, PC

Doing business as Riverside Spine & physical Medicine

  • Orthopaedic Surgery Physician
  • Clarksville, TN
National Provider Identifier
1720407570
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD28572 Issued in TN
Legal business name
RIVERSIDE SPINE & PHYSICAL MEDICINE, PC
Doing business as
Riverside Spine & physical Medicine
Practice address
121 W Dunbar Cave Rd
Clarksville, TN 37040-6037
Phone
(931) 542-9420
Fax
(931) 542-9422
NPI assigned
Apr 9, 2014
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Cynthia J Chester, CPC,CPB,CPMA,CTA
Title
Admin
Phone
(931) 542-9420

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Chiropractor 111N00000X
Orthopaedic Surgery Physician 207X00000X MD28572 TN Primary
Physical Medicine & Rehabilitation Physician 208100000X

Addresses

Primary practice location

121 W Dunbar Cave Rd
Clarksville, TN 37040-6037

Mailing address

121 W Dunbar Cave Rd
Clarksville, TN 37040-6037
Phone (931) 542-9420

Other identifiers 2

IdentifierTypeStateIssuer
1336490266OtherIL1336490266
1598899429OtherTN1598899429

Other names 1

  • Riverside Spine & physical Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140619002243 TN Part B Supplier - Clinic/Group Practice 1456575141 Receives reassigned benefits from 11 practitioners
Practice locations: Clarksville, TN
O20150430000771 TN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1456575141 Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

121 W Dunbar Cave Rd
Clarksville, TN 37040
Phone (931) 542-5420

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1720407570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W DUNBAR CAVE RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406037",
            "telephone_number": "931-542-9420",
            "fax_number": "931-542-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W DUNBAR CAVE RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406037",
            "telephone_number": "931-542-9420",
            "fax_number": "931-542-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE SPINE & PHYSICAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "CHESTER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "931-542-9420",
        "authorized_official_credential": "CPC,CPB,CPMA,CTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD28572",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1336490266",
            "identifier": "1336490266",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1598899429",
            "identifier": "1598899429",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Spine & physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.