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EAGLE HARBOR PRIMARY CARE
NPI 1215953872
Family Medicine in Carrollton, VA

Active since July 15, 2006CLIA 49D1020965 · Microscopy
13478 CARROLLTON BLVD, UNIT D&E, CARROLLTON, VA 23314(757) 238-7043(757) 238-7052 Get Directions Write a Review

NPPES record last updated: October 15, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Eagle Harbor Primary Care NPPES

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

EAGLE HARBOR PRIMARY CARE (NPI 1215953872) is a healthcare organization registered as a family medicine in Carrollton, Virginia and active in the NPI registry since July 2006. The organization holds a CLIA Microscopy certificate valid through March 17, 2027 and lists James Lesnick, Vice President, as its authorized official.

NPPES Registry Identity

NPI1215953872
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRIVERSIDE PHYSICIAN SERVICES INC
Location Address13478 CARROLLTON BLVD, UNIT D&ECarrollton, VA 23314-3208
Mailing Address856 J Clyde Morris Blvd, Suite ANewport News, VA 23601-1318 · (757) 594-4006 · Fax (757) 534-5190
Phone(757) 238-7043
Fax(757) 238-7052
Organization SubpartYesParent: Riverside Healthcare Associates
Authorized OfficialJames LesnickVice President · (757) 594-4006
Enumeration DateJuly 15, 2006
Last NPPES UpdateOctober 15, 2014
✔ NPI 1215953872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
13478 CARROLLTON BLVD, Carrollton, VA 23314
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Other Names 1

Doing Business AsEagle Harbor Primary Care

Other Identifiers 1

Medicare PINC03953VA

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

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 for Provider-Performed Microscopy Procedures (PPMP) 49D1020965

Eagle Harbor Primary Care · Carrollton, VA
Active · expires Mar 17, 2027
CLIA Number49D1020965
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2025
Certificate Expiration DateMarch 17, 2027
Laboratory DirectorLisa Knust
Laboratory Phone(757) 238-7043
Laboratory LocationEagle Harbor Primary Care13478 Carrollton Boulevard - Unit D And E, Carrollton, VA 23314
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

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

LISA MARIE KNUST MD
Family Medicine
13478 CARROLLTON BLVD, UNITS D & E
CARROLLTON, VA 23314
Isle of Wight County (757) 238-7043
AMERICARE PLUS, LLC.
Case Management
13478 CARROLLTON BLVD
CARROLLTON, VA 23314
Isle of Wight County (757) 356-1700
AMY ELIZABETH BALKA MD
Family Medicine
13478 CARROLLTON BLVD, UNIT D & E
CARROLLTON, VA 23314
Isle of Wight County (757) 238-7043
MICHELLE REID FRICKANISCE NP
Nurse Practitioner (Family)
13478 CARROLLTON BLVD, UNITS D & E
CARROLLTON, VA 23314
Isle of Wight County (757) 238-7043
DR. DANIEL CHARLES TOLAND III D.C.
Chiropractor
13478 CARROLLTON BLVD, SUITE 0
CARROLLTON, VA 23314
Isle of Wight County (757) 745-7367

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 Physician Services Inc's NPI number?

The NPI number for Riverside Physician Services Inc is 1215953872. It was assigned to this organization in the NPPES registry on July 15, 2006. The provider is doing business as Eagle Harbor Primary Care.

Where is Riverside Physician Services Inc located?

Riverside Physician Services Inc is located at 13478 Carrollton Blvd Unit D&e, Carrollton, VA 23314. The listed phone number is (757) 238-7043.

What is Riverside Physician Services Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Riverside Physician Services Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 49D1020965) is associated with this NPI, valid through March 17, 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 Physician Services Inc was last updated on October 15, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.