Riverside Physician Services Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RIVERSIDE PHYSICIAN SERVICES INC

Doing business as

Elizabeth Lakes Family Practice

Practice address

191 Fox Hill Rd
Hampton, VA 23669-2360

Phone

(757) 850-1311

Fax

(757) 850-7315

NPI assigned

Jul 14, 2006

Organization subpart

Yes

Parent organization

RIVERSIDE PHYSICIAN SERVICES INCAs reported in NPPES

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

Authorized official

Name

Billie Jo Brown

Title

Credentialing Manager

Phone

(757) 316-5901

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Lakes Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Part of

RPS Ta Rvrsde Tpphnck GRP

Member of 1

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

• Rector & Visitors of the University of Virginia

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Staunton, VA
  • NPI 1407212954

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1740206499",
    "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": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 FOX HILL RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236692360",
            "telephone_number": "757-850-1311",
            "fax_number": "757-850-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BILLIE JO",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "757-316-5901"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elizabeth Lakes Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services Inc
• Riverside Physician Services, Inc
• Riverside Physicians Services Inc
• Riverside Retirement Services, Inc.

• Family Medicine Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.