Riverside Physician Services, Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

RIVERSIDE PHYSICIAN SERVICES, INC.

Doing business as

Riverside Walter Reed Urology

Practice address

7552 Hospital Drive
Suite 302
Gloucester, VA 23061

Phone

(804) 693-9062

Fax

(804) 693-9875

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Michael J Doucette

Title

Vice President

Phone

(757) 594-4006

Specialties & licenses 1

Addresses

Other names 1

• Riverside Walter Reed Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811918444",
    "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": "757-594-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 HOSPITAL DRIVE",
            "address_2": "SUITE 302",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "23061",
            "telephone_number": "804-693-9062",
            "fax_number": "804-693-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOUCETTE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "757-594-4006"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Walter Reed Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riverside Physician Services Inc (Riverside Pulmonary and Sleep Specialists Gloucester)
• Riverside Physician Services Inc (Internal Medicince Associates of Gloucester)
• Riverside Physician Services Inc (Gloucester Surgery)
• Riverside Physician Services, Inc (Cardiovascular Center of Hampton Roads)
• Riverside Physician Services, Inc (Gloucester Gastroenterology)
• Robert Winfield Klink (Gloucester Women's Clinic)
• Hannah Roberts, LPC
• Burma P Roddy, LCSW
• Aidan Rourk, DPT
• Swetha Sabbineni

• Urology Physician in Gloucester, VA
• Providers in Gloucester, VA by specialty
• Urology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.