RIVERSIDE GASTROENTEROLOGY PC (NPI# 1669762480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669762480 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE GASTROENTEROLOGY PC |
| Practice Address |
1304 Somerville Rd Se Decatur AL 35601-4354 |
| Practice Telephone | 2562602333 |
| Practice Fax Number | 2562602336 |
| Mailing Telephone | 2562602333 |
| Mailing Fax Number | 2562602336 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |
| Authorized Official Name | THOMAS SHORT (PRESIDENT) |
| Authorized Official Telephone | 2562602333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Street Address |
1304 SOMERVILLE RD SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952875932 | Aimee Lin Simington | Internal Medicine | 609 Medical Center Dr Ste 2600, Decatur, TX 76234-3846 | 2019-01-14 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1417134008 | Andrew Simpson | Internal Medicine | 2675 N Decatur Rd Ste 506, Decatur, GA 30033-6134 | 2008-01-25 |
| 1124180674 | Jeanette N Keith | Internal Medicine | 1208 Somerville Rd Se, Decatur, AL 35601-4335 | 2006-12-14 |
| 1417027277 | Shirley Ann Harris | Internal Medicine | 3292 Mountain Dr, Suite A, Decatur, GA 30032-1102 | 2006-11-09 |
| 1649206095 | Khurshid Yousuf | Internal Medicine | 1103 15th Ave Se, Decatur, AL 35601-3345 | 2006-06-25 |
| 1790761443 | Attupuram Joseph Alexander | Internal Medicine | 2282 Highway 31 S, Suite 117, Decatur, AL 35601-6512 | 2005-12-15 |
| 1851377527 | Venkata Babu Kantamneni | Internal Medicine | 2828 Highway 31 South, Suite 117, Decatur, AL 35602 | 2005-12-15 |
| 1730184284 | Eric Donovan High | Internal Medicine | 2675 North Decatur Road, Suite 506, Decatur, GA 30033-2111 | 2005-06-20 |
| Find all providers in DECATUR | ||||
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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.