NPI Code Detail JSON Logo

1588591077 NPI number — RIVER BEND FAMILY MEDICINE LLC

NPI Number: 1588591077
Health Care Provider/Practitioner: RIVER BEND FAMILY MEDICINE LLC

Information about “1588591077” NPI (RIVER BEND FAMILY MEDICINE LLC) exists in 1588591077 in HTML format HTML  |  1588591077 in plain Text format TXT  |  1588591077 in PDF (Portable Document Format) PDF  |  1588591077 in an XML format XML  formats.

NPI Number : 1588591077 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1588591077",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "RIVER BEND FAMILY MEDICINE LLC",
    "ParentOrgTIN": null,
    "OrgName": "RIVER BEND FAMILY MEDICINE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "131 N PENNSYLVANIA AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HANCOCK",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21750-1135",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "301-678-7007",
    "MailingAddressFaxNumber": "301-678-7009",
    "FirstLinePracticeLocationAddress": "10302 EZRA DR",
    "SecondLinePracticeLocationAddress": "103",
    "PracticeLocationAddressCityName": "HAGERSTOWN",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21740",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "301-678-7007",
    "PracticeLocationAddressFaxNumber": "301-678-7009",
    "EnumerationDate": "05/07/2026",
    "LastUpdateDate": "05/07/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HOOVER",
    "AuthorizedOfficialFirstName": "HEATHER",
    "AuthorizedOfficialMiddleName": "JOETTE",
    "AuthorizedOfficialTitle": "PRACTICE MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "301-678-7007",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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