RIVERSIDE PRIMARY CARE ADULT AND GERIATRIC MEDICINE PLLLP
NPI 1003693961
Family Medicine - Geriatric Medicine in Boise, ID

Q: What is Riverside Primary Care Adult And Geriatric Medicine Plllp's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Active since September 13, 2023CLIA 13D2293730 · Waiver

1673 W SHORELINE DR STE 100, BOISE, ID 83702(208) 593-3054 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Riverside Primary Care Adult And Geriatric Medicine Plllp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVERSIDE PRIMARY CARE ADULT AND GERIATRIC MEDICINE PLLLP (NPI 1003693961) is a healthcare organization registered as a geriatric medicine in Boise, Idaho and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through November 13, 2027 and lists Jessica Long, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1003693961

Entity TypeOrganization

Primary Taxonomy207QG0300X

Legal Business NameRIVERSIDE PRIMARY CARE ADULT AND GERIATRIC MEDICINE PLLLP

Location Address1673 W SHORELINE DR STE 100Boise, ID 83702-6749

Mailing Address1673 W Shoreline Dr Ste 100Boise, ID 83702-6749

Phone(208) 593-3054

Organization SubpartNo

Authorized OfficialJessica LongCo-owner · (208) 850-1940

Enumeration DateSeptember 13, 2023

NPPES CertifiedSeptember 13, 2023

✔ NPI 1003693961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QG0300X

Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

1673 W SHORELINE DR STE 100, Boise, ID 83702

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2293730

Riverside Primary Care Adult & Geriatric Medicine · Boise, ID

Active · expires Nov 13, 2027

CLIA Number13D2293730

Laboratory TypePhysician Office

Certificate Effective DateNovember 14, 2025

Certificate Expiration DateNovember 13, 2027

Laboratory DirectorCynthia Bryson

Laboratory Phone(208) 593-3054

Laboratory LocationRiverside Primary Care Adult & Geriatric Medicine1673 W Shoreline Dr Ste 100, Boise, ID 83702

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLA D DIRMANN NP

Nurse Practitioner (Family)

1673 W SHORELINE DR STE 100
BOISE, ID 83702

Ada County (208) 593-3054

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riverside Primary Care Adult And Geriatric Medicine Plllp's NPI number?

The NPI number for Riverside Primary Care Adult And Geriatric Medicine Plllp is 1003693961. It was assigned to this organization in the NPPES registry on September 13, 2023.

Where is Riverside Primary Care Adult And Geriatric Medicine Plllp located?

Riverside Primary Care Adult And Geriatric Medicine Plllp is located at 1673 W Shoreline Dr Ste 100, Boise, ID 83702. The listed phone number is (208) 593-3054.

What is Riverside Primary Care Adult And Geriatric Medicine Plllp's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Does Riverside Primary Care Adult And Geriatric Medicine Plllp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2293730) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Riverside Primary Care Adult And Geriatric Medicine Plllp was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.