Riverside Medical Clinic
NPI 1811206923ActiveOrganization· Family Medicine· Lake City, AR
Family Medicine in Lake City, Arkansas, registered in NPPES in October 2010. The authorized official on file is Tommy Wagner, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1811206923 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 7, 2010 |
| Last updated in NPPES | Aug 2, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AR) |
|---|
Other family medicine physicians in Lake City
- 1639136609