River Ridge Pediatrics, P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

RIVER RIDGE PEDIATRICS, P.A.

Practice address

1526 Leander Rd
Georgetown, TX 78628-8801

Phone

(512) 930-1309

Fax

(512) 863-5222

NPI assigned

Apr 23, 2012

Organization subpart

No

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

Authorized official

Name

Adana Milliken Gipson, M.D.

Title

President/Medical Director

Phone

(512) 930-1309

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1790042158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 LEANDER RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288801",
            "telephone_number": "512-930-1309",
            "fax_number": "512-863-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 LEANDER RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288801",
            "telephone_number": "512-930-1309",
            "fax_number": "512-863-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RIDGE PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "GIPSON",
        "authorized_official_first_name": "ADANA",
        "authorized_official_middle_name": "MILLIKEN",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "512-930-1309",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.