Riverside Medical Associates, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

24818 Issued in NC

Legal business name

RIVERSIDE MEDICAL ASSOCIATES, PLLC

Doing business as

Riverside Medical Associates, PLLC

Practice address

702 13TH St
North Wilkesboro, NC 28659-4075

Phone

(336) 667-5296

Fax

(336) 667-0864

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Greta B Templeton

Title

Insurance Manager

Phone

(336) 667-5296

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Riverside Medical Associates, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela L Myers, P.A.-C

  • Medical Physician Assistant
  • North Wilkesboro, NC
  • NPI 1720129380
  Medicare reassignment

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495152000000",
    "number": "1821173857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1348",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286591348",
            "telephone_number": "336-667-5296",
            "fax_number": "336-667-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 13TH ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594075",
            "telephone_number": "336-667-5296",
            "fax_number": "336-667-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-05-19",
        "status": "A",
        "authorized_official_last_name": "TEMPLETON",
        "authorized_official_first_name": "GRETA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "336-667-5296",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "24818",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "100774",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "02559",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6902559",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Associates, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Ricketts, DDS
• Casey Riddick
• John Joseph Riedel Jr., C.R.N.A.
• Callie Ryann Rieder
• Shauna Handy Riggans
• Danna Michelle Rizoti
• Angie Roark, PHARM.D.
• Robert B. Taylor
• Robert F Ricketts, DDS, PA
• Christopher Eugene Roberts, DDS, PA

• Internal Medicine Physician in North Wilkesboro, NC
• Providers in North Wilkesboro, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; 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.