Organization Active NPI

Riverside Family Health LLC

  • Family Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1851652416
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-093034 Issued in AL
Legal business name
RIVERSIDE FAMILY HEALTH LLC
Practice address
1501 7TH St SE Ste a
Decatur, AL 35601-3375
Phone
(256) 355-7665
Fax
(256) 686-3241
NPI assigned
May 30, 2012
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Crystal Leann Landrum, CRNPNPI 1851658496
Title
Ceo
Phone
(256) 355-7665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-093034 AL Primary

Addresses

Primary practice location

1501 7TH St SE Ste a
Decatur, AL 35601-3375

Mailing address

1501 7TH St SE Ste a
Decatur, AL 35601-3375
Phone (256) 355-7665

Other identifiers 4

IdentifierTypeStateIssuer
138745MedicaidAL
51126863OtherALBCBS
12404856OtherALCAQH
140473MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crystal.landrum@riverhealth.direct.medconnect-inc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150112001990 AL Part B Supplier - Clinic/Group Practice 0042534422 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2101314Riverside Family Health LLC1501 7TH St SE, Suite a, Decatur, AL 35601Certificate of waiverAug 31, 2027

National Provider Directory

National Provider Directory

Locations

1304 13th Ave SE
Ste C
Decatur, AL 35601
Phone (256) 351-9216

1304 13th Ave SE
Ste D
Decatur, AL 35601
Phone (256) 340-2560

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1851652416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 7TH ST SE STE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013375",
            "telephone_number": "256-355-7665",
            "fax_number": "256-686-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 7TH ST SE STE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013375",
            "telephone_number": "256-355-7665",
            "fax_number": "256-686-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE FAMILY HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "LANDRUM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "LEANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-355-7665",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-093034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138745",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51126863",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12404856",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140473",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.landrum@riverhealth.direct.medconnect-inc.com",
            "affiliation": "N",
            "endpointDescription": "Medconnect EHR Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1501 7th St SE Ste A",
            "city": "Decatur",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356013375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.