RIVERS EDGE BOUTIQUE MEDICINE LLC
NPI 1033970454
Family Medicine - Adult Medicine in New Port Richey, FL

Q: What is Rivers Edge Boutique Medicine LLC's NPI number?

The NPI number for Rivers Edge Boutique Medicine LLC is 1033970454. It was assigned to this organization in the NPPES registry on January 22, 2024.

Q: What is Rivers Edge Boutique Medicine LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Active since January 22, 2024

5647 MAIN ST STE 1&2, NEW PORT RICHEY, FL 34652(727) 831-8376 Get Directions Write a Review

NPPES record last updated: January 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Rivers Edge Boutique Medicine Llc NPPES

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

RIVERS EDGE BOUTIQUE MEDICINE LLC (NPI 1033970454) is a healthcare organization registered as an adult medicine in New Port Richey, Florida and active in the NPI registry since January 2024. The organization maintains a secondary practice location in Dunedin and lists Tracy Greene, Owner, as its authorized official.

NPPES Registry Identity

NPI1033970454

Entity TypeOrganization

Primary Taxonomy207QA0505X

Legal Business NameRIVERS EDGE BOUTIQUE MEDICINE LLC

Location Address5647 MAIN ST STE 1&2New Port Richey, FL 34652-2641

Mailing Address5647 Main St Ste 1&2New Port Richey, FL 34652-2641 · (727) 831-8376

Phone(727) 831-8376

Organization SubpartNo

Authorized OfficialTracy GreeneOwner · (727) 342-4955

Enumeration DateJanuary 22, 2024

NPPES CertifiedJanuary 22, 2024

✔ NPI 1033970454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

5647 MAIN ST STE 1&2, New Port Richey, FL 34652

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Secondary Practice Location 1

Location 11454 Main St Ste BDunedin, FL 34698-6254 · Phone (727) 831-8376

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Rivers Edge Boutique Medicine LLC's NPI number?

The NPI number for Rivers Edge Boutique Medicine LLC is 1033970454. It was assigned to this organization in the NPPES registry on January 22, 2024.

Where is Rivers Edge Boutique Medicine LLC located?

Rivers Edge Boutique Medicine LLC is located at 5647 Main St Ste 1&2, New Port Richey, FL 34652. The listed phone number is (727) 831-8376.

What is Rivers Edge Boutique Medicine LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Rivers Edge Boutique Medicine LLC was last updated on January 22, 2024. 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.