NPIMap

Organization Active NPI

Riverside Health Center Lab

  • Family Medicine Physician
  • Belle, WV
National Provider Identifier
1780087338
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVERSIDE HEALTH CENTER LAB
Practice address
1 Warrior Way Ste 103
Belle, WV 25015-1356
Phone
(304) 734-2040
Fax
(304) 734-2047
NPI assigned
Sep 26, 2014
Last updated
Sep 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Jennifer Russell
Title
Administrative Assistant
Phone
(304) 734-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 Warrior Way Ste 103
Belle, WV 25015-1356

Mailing address

PO Box 70
Dawes, WV 25054-0070
Phone (304) 734-2040

National Provider Directory

National Provider Directory
Tax ID family
Cabin Creek Health Center Pharmacy13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1780087338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "DAWES",
            "state": "WV",
            "postal_code": "250540070",
            "telephone_number": "304-734-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WARRIOR WAY STE 103",
            "city": "BELLE",
            "state": "WV",
            "postal_code": "250151356",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE HEALTH CENTER LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "304-734-2040"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.