Active NPI
Riverside Medical Center
- Emergency Medicine Physician
- Franklinton, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- RIVERSIDE MEDICAL CENTER
- Practice address
- 1900 Main St
Franklinton, LA 70438-3688 - Phone
- (985) 839-4431
- Fax
- (985) 839-0319
- NPI assigned
- Dec 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stacey K McGraw
- Title
- Business Office Director
- Phone
- (985) 795-4168
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
1900 Main St
Franklinton, LA 70438-3688
Mailing address
1900 Main St
Franklinton, LA 70438-3688
Phone (985) 839-4431
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1084646 | Medicaid | LA | |
| 04798 | Other | LA | BLUE CROSS PHY |
| 22656 | Other | LA | BLUE CROSS PHYSICIAN |
| 57311 | Other | LA | MEDICARE PROFESSIONAL NUMBER |
Other names 1
- Riverside Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040407000623 | LA | Part B Supplier - Clinic/Group Practice | 3173430196 |
Receives reassigned benefits from 18 practitioners 6 other NPIs on this enrollment Practice locations: Franklinton, LA |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Franklinton, LA
- NPI 1881756989
3173430196
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
807 Riverside Dr
Franklinton, LA 70438
Phone (985) 795-4122
2004 J Marvin Magee Dr
Franklinton, LA 70438
Phone (985) 419-9939
809 Riverside Dr
Franklinton, LA 70438
Phone (985) 795-4208
Ownership & related parties
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Riverside Medical Center | Hospital | 5% Or Greater Direct Ownership Interest | Jul 2, 2004 |
| Riverside Family Care Clinic | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 2000 |
| Thomas Community Health Center | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Dec 29, 2020 |
Owned or controlled facilities with NPI records 8
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Clinic/Center
- Franklinton, LA
- NPI 1093189797
5% Or Greater Direct Ownership Interest
-
- Clinic/Center
- Franklinton, LA
- NPI 1104290949
5% Or Greater Direct Ownership Interest
-
- Rural Health Clinic/Center
- Franklinton, LA
- NPI 1518955541
5% Or Greater Direct Ownership Interest
-
- Clinic/Center
- Franklinton, LA
- NPI 1538634977
5% Or Greater Direct Ownership Interest
-
- Rural Health Clinic/Center
- Franklinton, LA
- NPI 1578937371
5% Or Greater Direct Ownership Interest
-
- Critical Access Hospital
- Franklinton, LA
- NPI 1700874062
5% Or Greater Direct Ownership Interest
-
- Clinic/Center
- Franklinton, LA
- NPI 1710438361
5% Or Greater Direct Ownership Interest
-
- Clinic/Center
- Franklinton, LA
- NPI 1952751679
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Practitioners 35
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Franklinton, LA
- NPI 1891723854
LA
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- New Iberia, LA
- NPI 1811197015
LA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663545600000",
"number": "1982767166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 MAIN ST",
"city": "FRANKLINTON",
"state": "LA",
"postal_code": "704383688",
"telephone_number": "985-839-4431",
"fax_number": "985-839-0319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 MAIN ST",
"city": "FRANKLINTON",
"state": "LA",
"postal_code": "704383688",
"telephone_number": "985-839-4431",
"fax_number": "985-839-0319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERSIDE MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-18",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A",
"authorized_official_last_name": "MCGRAW",
"authorized_official_first_name": "STACEY",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
"authorized_official_telephone_number": "985-795-4168"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1084646",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PHY",
"identifier": "04798",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PHYSICIAN",
"identifier": "22656",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROFESSIONAL NUMBER",
"identifier": "57311",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Riverside Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Riverside Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Franklinton, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.