RIVER VALLEY PEDIATRICS AND ADOLESCENT MEDICINE (NPI# 1639660194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639660194 |
| Entity Type | Organization |
| Organization Name | RIVER VALLEY PEDIATRICS AND ADOLESCENT MEDICINE |
| Practice Address |
20 Water St Chester CT 06412 |
| Mailing Address |
2 Deep Hollow Rd Chester CT 06412-1112 |
| Practice Telephone | 4014901289 |
| Mailing Telephone | 8605320525 |
| Mailing Fax Number | 8604835134 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | DR. ELIZABETH MADELINE BIRD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8605320525 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
53136 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008080251 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | RIVER VALLEY PEDIATRICS AND ADOLESCENT MEDICINE LLC | 2 Deep Hollow Drive, Chester, CT 06412 |
| Street Address |
20 WATER ST |
| City | CHESTER |
| State | CT |
| Zip Code | 06412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598834152 | Elizabeth Madeline Bird | Pediatrics | 20 Water St, Chester, CT 06412 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184866618 | Donald Dean Yousey | Occupational Therapist | 3 South Wig Hill Rd., Chester, CT 06412 | 2009-03-30 |
| 1972996049 | Pamela Lape | Psychologist | 15 North Main Street, Reflections of Chester, Chester, CT 06412 | 2015-03-12 |
| 1316960818 | Andrea Dingman Kosack | Physician Assistant | 20 York Street, Ynhh Nbscu, New Haven, CT 06412 | 2006-07-25 |
| 1508985672 | Christopher J Kearns | Dentist | 4 Water St, Chester, CT 06412-0510 | 2007-03-28 |
| 1710243738 | Regina Marie Walsh | Counselor | 15 North Main Street, Chester, CT 06412-0641 | 2012-04-03 |
| 1861925208 | Samantha Elsa Grass | Behavioral Analyst | 89 Cedar Lake Rd, Chester, CT 06412-1008 | 2017-04-04 |
| 1306246640 | Oliver Winter | Internal Medicine | 61 Winthrop Rd, Chester, CT 06412-1036 | 2014-08-22 |
| 1922424084 | Hemanth Yalavarthy | Physical Therapist | 317 W Main St, Chester, CT 06412-1057 | 2014-03-13 |
| 1467892356 | Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | 317 W Main St, Chester, CT 06412-1057 | 2013-06-25 |
| 1245226521 | Aaron Manor Inc | Skilled Nursing Facility | 3 S Wig Hill Rd, Chester, CT 06412-1106 | 2005-09-22 |
| Find all providers in zip 06412 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1548282452 | Premier Clinics Pa | Clinic/Center | 120 York St, Chester, SC 29706-1484 | 2006-07-24 |
| 1720606676 | We Care Clinic | Clinic/Center | 9 Chester Plz, Chester, MD 21619-2418 | 2020-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447578 | Luca Health & Wellness, LLC | Clinic/Center | 2475 Albany Ave Ste 205, West Hartford, CT 06117-2523 | 2020-11-04 |
| 1699307751 | Pride Comprehensive Primary Care LLC | Clinic/Center | 7 Warren Rd, Wolcott, CT 06716-3015 | 2020-02-06 |
| 1316405186 | Ct Optimal Wellness, LLC | Clinic/Center | 115 Technology Dr Unit A103, Trumbull, CT 06611-6338 | 2019-03-11 |
| 1922586809 | Emmaus Health LLC | Clinic/Center | 945 Main St Ste 205, Manchester, CT 06040-6064 | 2018-08-01 |
| 1841781382 | Clifford W. Beers Guidance Clinic Inc | Clinic/Center | 41 Marne St, Hamden, CT 06514 | 2018-05-21 |
| 1598284622 | Np Wellness Care | Clinic/Center | 253 Fairlawn Dr, Torrington, CT 06790-5809 | 2017-09-09 |
| 1245773191 | Anchor Health Initiative Corp. | Clinic/Center | 30 Myano Ln Ste 16, Stamford, CT 06902-4532 | 2016-11-27 |
| 1588114870 | Whole Self Wellness, LLC | Clinic/Center | 144 Banjo Sullivan Rd, Griswold, CT 06351-1201 | 2016-10-11 |
| 1265892541 | Amanda M Swan Aprn LLC | Clinic/Center | 33 Harmund Pl, Wethersfield, CT 06109-1209 | 2016-03-01 |
| 1215321666 | Grand Medical LLC | Clinic/Center | 515 Higgins Rd, Cheshire, CT 06410-3326 | 2015-03-24 |
| Find all providers with the same taxonomy | ||||
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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.