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RIVERSIDE PHYSICIAN SERVICES INC NPI 1013933977


NPI Information

NPI: 1013933977
Provider Name: RIVERSIDE PHYSICIAN SERVICES INC

Doing Business As: BRUTON AVENUE FAMILY PRACTICE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 49D0669759

Address:
12 BRUTON AVE
NEWPORT NEWS, VA
ZIP 23601
Phone: (757) 594-4111
Get Directions

RIVERSIDE PHYSICIAN SERVICES INC is a family medicine in Newport News, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RIVERSIDE PHYSICIAN SERVICES INC NPI is 1013933977. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bruton Avenue Family Practice.

The provider's business location address is:

12 BRUTON AVE
NEWPORT NEWS, VA
ZIP 23601-602
Phone: (757) 594-4111
Fax: (757) 594-4115

The provider's authorized official is James Lesnick .
The authorized official title is Vice President and has the following contact phone number (757) 594-4006.

The CLIA number assigned to this NPI record is 49D0669759 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/14/2006 and was last updated on 10/14/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C03953MEDICARE PINVIRGINIA
21081570024MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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