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RIVERSIDE MEDICAL CLINIC INC
NPI 1508263088
Nurse Practitioner - Family in Grundy, VA

Active since November 26, 2014CLIA 49D2089561 · Waiver
20886 RIVERSIDE DR, GRUNDY, VA 24614(276) 935-7515(276) 935-4351 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Riverside Medical Clinic Inc NPPES

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

RIVERSIDE MEDICAL CLINIC INC (NPI 1508263088) is a healthcare organization registered as a family in Grundy, Virginia and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through January 4, 2027 and lists Tara S Williams, President, as its authorized official.

NPPES Registry Identity

NPI1508263088
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameRIVERSIDE MEDICAL CLINIC INC
Location Address20886 RIVERSIDE DRGrundy, VA 24614-9597
Mailing AddressPo Box 1030Grundy, VA 24614-1030 · (276) 935-7515 · Fax (276) 935-4351
Phone(276) 935-7515
Fax(276) 935-4351
Organization SubpartNo
Authorized OfficialTara S WilliamsPresident · (276) 935-7515
Enumeration DateNovember 26, 2014
Last NPPES UpdateAugust 12, 2025
NPPES CertifiedAugust 12, 2025
✔ NPI 1508263088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in VA · 0024168117
20886 RIVERSIDE DR, Grundy, VA 24614
Open in Google Maps ↗

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 of Waiver 49D2089561

Riverside Medical Clinic · Grundy, VA
Active · expires Jan 4, 2027
CLIA Number49D2089561
Laboratory TypePhysician Office
Certificate Effective DateJanuary 5, 2025
Certificate Expiration DateJanuary 4, 2027
Laboratory DirectorTara Matney
Laboratory Phone(276) 935-7515
Laboratory LocationRiverside Medical Clinic20886 Riverside Drive, Grundy, VA 24614
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

KOURTNEY COOK
Nurse Practitioner
20886 RIVERSIDE DR
GRUNDY, VA 24614
Buchanan County (276) 935-7515
TARA WILLIAMS-MATNEY ARNP
Nurse Practitioner
20886 RIVERSIDE DR
GRUNDY, VA 24614
Buchanan County (276) 935-7515
ALEXANDRA LOUISE HURLEY NP
Nurse Practitioner (Family)
20886 RIVERSIDE DR
GRUNDY, VA 24614
Buchanan County (276) 935-7515

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 Medical Clinic Inc's NPI number?

The NPI number for Riverside Medical Clinic Inc is 1508263088. It was assigned to this organization in the NPPES registry on November 26, 2014.

Where is Riverside Medical Clinic Inc located?

Riverside Medical Clinic Inc is located at 20886 Riverside Dr, Grundy, VA 24614. The listed phone number is (276) 935-7515.

What is Riverside Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Riverside Medical Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2089561) is associated with this NPI, valid through January 4, 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 Medical Clinic Inc was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.