NPIMap

Organization Active NPI

Riverside Physician Services, Inc

Doing business as Riverside Endocrinology & Diabetes Specialists Williamsburg

  • Endocrinology, Diabetes & Metabolism Physician
  • Williamsburg, VA
National Provider Identifier
1861729915
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
RIVERSIDE PHYSICIAN SERVICES, INC
Doing business as
Riverside Endocrinology & Diabetes Specialists Williamsburg
Practice address
3700 Battery Blvd Ste 202
Williamsburg, VA 23185-4888
Phone
(757) 645-3460
Fax
(757) 645-3481
NPI assigned
Nov 11, 2009
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE PHYSICIAN SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Mr. Braden Miller
Title
Cfo
Phone
(757) 316-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

3700 Battery Blvd Ste 202
Williamsburg, VA 23185-4888

Mailing address

856 J Clyde Morris Blvd
Ste a
Newport News, VA 23601-1318
Phone (757) 316-5800

Other names 1

  • Riverside Endocrinology & Diabetes Specialists Williamsburg Doing business as

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
49D2077670Riverside Endocrinology and Diabetes Specialists3700 Battery Boulevard, Suite 202, Williamsburg, VA 23185Certificate of waiverOct 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Riverside OB-GYN88 organizations share this tax ID, including this one
Part of
Riverside OB-GYN

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

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": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1861729915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318",
            "telephone_number": "757-316-5800",
            "fax_number": "757-534-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 BATTERY BLVD STE 202",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231854888",
            "telephone_number": "757-645-3460",
            "fax_number": "757-645-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE PHYSICIAN SERVICES, INC",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-316-5800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Endocrinology & Diabetes Specialists Williamsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.