Riverside Health Source LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

RIVERSIDE HEALTH SOURCE LLC

Practice address

289 Hospital Rd
Tappahannock, VA 22560-5145

Phone

(804) 443-6130

NPI assigned

Oct 21, 2020

Organization subpart

No

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

Authorized official

Name

Walter W Austin Jr.

Title

Sr Vice President/Cfo

Phone

(757) 875-7545

Specialties & licenses 1

Addresses

Tax ID family

Riverside Health Source LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Riverside Health Source LLC

  • Home Health Agency
  • Tappahannock, VA
  • NPI 1578162517
  NPD tax ID

Locations

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1881293835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BLVD STE 800",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084487",
            "telephone_number": "757-875-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 HOSPITAL RD",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225605145",
            "telephone_number": "804-443-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE HEALTH SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SR VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "757-875-7545",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Reed, LPC
• Diogo Ribeiro de Sene, M.D.
• River Run Anesthesia LLC
• Riverside Emergency Physicians LLP
• Riverside Health Source LLC
• Riverside Physician Services Inc
• Riverside Physician Services Inc.
• Riverside Tappahannock Hospital Inc
• Riverside Tappahannock Hospital Inc
• Riverside Tappahannock Hospital Inc

• Community Based Hospice Care Agency in Tappahannock, VA
• Providers in Tappahannock, VA by specialty
• Community Based Hospice Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.