RIVER PARK ASC LLC (NPI# 1144216847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144216847 |
| Entity Type | Organization |
| Organization Name | RIVER PARK ASC LLC |
| Practice Address |
107 Front St Ste.1100 Vidalia LA 71373-2836 |
| Practice Telephone | 3183362218 |
| Mailing Telephone | 3183362218 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | MARCI MCGRAW (CEO) |
| Authorized Official Telephone | 3183362225 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
128 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03027576 | 05 | |
| LA | BLUE CROSS PROVIDER NUMBE | 190020258Z | 01 |
| LA | 1464015 | 05 |
| Street Address |
107 FRONT ST STE.1100 |
| City | VIDALIA |
| State | LA |
| Zip Code | 71373-2836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447251996 | Iley Floyd Dillon | Internal Medicine | 107 Front St, Suite 2109, Vidalia, LA 71373-2836 | 2005-08-09 |
| 1992326359 | Riverpark Dermatology Services LLC | Dermatology | 107 Front St, Rm 1-129, Vidalia, LA 71373 | 2020-04-27 |
| 1356875637 | Perfusion Vascular Vidalia LLC | Surgery | 107 Front St, Vidalia, LA 71373-2836 | 2017-04-13 |
| 1275985012 | Riverfront Urgent Care Center LLC | Orthopaedic Surgery | 107 Front St, Ste 2138, Vidalia, LA 71373-2836 | 2016-07-05 |
| 1407249766 | Riverpark Counseling LLC | Social Worker | 107 Front St, Ste 2134, Vidalia, LA 71373-2836 | 2015-03-11 |
| 1700937950 | Michael R Wimberly II | Physical Therapist | 107 Front St, Suite 230, Vidalia, LA 71373-2836 | 2007-01-15 |
| 1336209550 | J H Fairbanks, Md Pllc | Orthopaedic Surgery | 107 Front St, Suite 230, Vidalia, LA 39120 | 2006-12-11 |
| 1649341082 | Lisa Cazalot | Nurse Practitioner | 107 Front St, Vidalia, LA 71373-2836 | 2006-11-09 |
| 1255421038 | Riverpark Laboratory Services | Clinical Medical Laboratory | 107 Front St, Vidalia, LA 71373-2836 | 2006-10-13 |
| 1730276965 | Riverpark Community Cath Lab, LLC | Clinic/Center | 107 Front St, Vidalia, LA 71373-2836 | 2006-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513494 | Total Urgent Care | Clinic/Center | 4014 Carter Street, Vidalia, LA 71373 | 2020-03-13 |
| 1609412097 | Hulin Urgent Care Services, LLC | Clinic/Center | 4319 Highway 84, Vidalia, LA 71373 | 2019-11-21 |
| 1720562556 | Neashion Marie Davis | Counselor | 1644 B Carter Street. Suite #2, Vidalia, LA 71373 | 2018-09-18 |
| 1992292403 | Angelica Francheska Woods | Counselor | 1644 B. Carter Street Suite 2, Vidalia, LA 71373 | 2018-04-19 |
| 1164973780 | Linda Sherbia | Counselor | 1644 B Carter St., Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1518418045 | Cheryl Clark | Case Manager/Care Coordinator | 1644 B Carter Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1972054500 | Sherry Cade | Counselor | 1644 B Carter Street, Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1457801136 | Sarai Johnson | Counselor | 1644 B Carter Street Suite 2, Vidalia, LA 71373 | 2016-10-06 |
| 1053766410 | Erin Fournet Woodruff | Physical Therapist | 402 Holly Street, Vidalia, LA 71373 | 2016-05-04 |
| 1184084113 | Troy Nolan Thomas Jr. | Counselor | 4012 Carter St., Vidalia, LA 71373 | 2016-03-03 |
| Find all providers in zip 71373 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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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.