LITTLE RIVER MEDICAL GROUP (NPI# 1093121741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093121741 |
| Entity Type | Organization |
| Organization Name | LITTLE RIVER MEDICAL GROUP |
| Practice Address |
1905 Sw H K Dodgen Loop Temple TX 76502-1814 |
| Practice Telephone | 2542982530 |
| Mailing Telephone | 2542982530 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |
| Authorized Official Name | JEFFREY P MADISON (CEO) |
| Authorized Official Telephone | 5124464500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558800706 | Little River Medical Group | Exclusive Provider Organization | 1 Chisholm Trl, Round Rock, TX 78681-5008 | 2017-02-21 |
| 1326442195 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1717 Sw H K Dodgen Loop, Suite 103, Temple, TX 76502-1838 | 2014-10-22 |
| 1699179465 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2014-10-22 |
| 1598169039 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1904 Railroad St, Georgetown, TX 78626-7718 | 2014-10-13 |
| 1124422662 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1512 Leander Rd, Georgetown, TX 78628-8801 | 2014-10-13 |
| 1639571052 | Little River Medical Group | Family Medicine | 5656 Bee Caves Rd, Suite M 300, West Lake Hills, TX 78746-5280 | 2014-09-17 |
| Street Address |
1905 SW H K DODGEN LOOP |
| City | TEMPLE |
| State | TX |
| Zip Code | 76502-1814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063410439 | Austin Wei Chang | Ophthalmology | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2005-07-11 |
| 1730645995 | Collins Family Pharmacy LLC | Pharmacy | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-02-13 |
| 1497230395 | Jennifer Smith | Nurse Practitioner | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2018-09-27 |
| 1093245854 | Jocelyn Cheung | Physical Therapist | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2017-06-14 |
| 1740736347 | Christie Lyn Torres | Nurse Practitioner | 1905 Sw H K Dodgen Loop, 1700 Brazos, Rockdale Tx 76567, Temple, TX 76502-1814 | 2016-09-01 |
| 1174977516 | Preston Neal Martin | Physical Therapist | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2016-04-22 |
| 1336544758 | Lindsey Nicole Willis | Nurse Practitioner | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2014-10-28 |
| 1699179465 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2014-10-22 |
| 1679904577 | Rockdale Blackhawk LLC | Durable Medical Equipment & Medical Supplies | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2013-12-03 |
| 1700148558 | Anthony J Collins | Pharmacist | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2012-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
| 1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
| 1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
| 1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
| 1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
| 1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
| 1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| Find all providers in zip 76502 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033566286 | Walk-in Clinic, LLC | Family Medicine | 1516 S 31st St, Suite B, Temple, TX 76504-6752 | 2016-05-18 |
| 1467815340 | Robert C Cortes | Family Medicine | 108 Tiger Cir, Temple, TX 76502-9219 | 2016-03-30 |
| 1306234521 | Heart of Texas Community Health Center, Inc. | Family Medicine | 600 S 25th St Ste 115, Temple, TX 76504-5227 | 2014-12-23 |
| 1215278882 | Manna Medical & Counseling | Family Medicine | 305 Carrollton Highway, Temple, GA 30178 | 2013-03-07 |
| 1619045499 | Bertram Vonzabern | Family Medicine | 311 Colburn Rd, Temple, NH 03084 | 2006-12-01 |
| 1588769871 | Alfredo Augusto Cisneros Sr. | Family Medicine | 1901 S 1st St (memorial Dr.), N/a, Temple, TX 76504 | 2006-09-13 |
| 1295795961 | Jennifer K. Flory | Family Medicine | 7556 Honeysuckle, Temple, TX 76502-5631 | 2006-03-25 |
| 1306805783 | Elizabeth W. Fomby | Family Medicine | 1402 W Avenue H, Temple, TX 76504-5342 | 2006-03-22 |
| 1205807120 | Esther Sun Lao | Family Medicine | 2420 Kingsbury Dr, Temple, TX 76502-7321 | 2006-01-30 |
| 1245226547 | Roger W. Kylberg | Family Medicine | 409 W Adams Ave, Temple, TX 76501-4211 | 2005-09-22 |
| Find all providers in TEMPLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.