NPIMap

Organization Active NPI

Riverside Medical Center

  • Emergency Medicine Physician
  • Franklinton, LA
National Provider Identifier
1982767166
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RIVERSIDE MEDICAL CENTER
Doing business as
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
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 names 1

  • Riverside Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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).

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 Directory

Locations

2004 J Marvin Magee Dr
Franklinton, LA 70438
Phone (985) 419-9939

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.

FacilityTypeRoleSince
Riverside Medical CenterFranklinton, LA, CCN 191313 Hospital 5% Or Greater Direct Ownership Interest Jul 2, 2004
Riverside Family Care ClinicFranklinton, LA, CCN 193441 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2000
Thomas Community Health CenterFranklinton, LA, CCN 198529 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.

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

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": [],
    "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

Verify at the official NPI Registry.