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RIVERSIDE FAMILY MEDICINE
NPI 1780720813
Family Medicine in Madison, TN

Active since January 29, 2007CLIA 44D0999367 · Waiver
1210 BRIARVILLE RD, BLDG F, MADISON, TN 37115(615) 860-0704(615) 860-9882 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 19, 2024, Dec 11, 2024, Jul 21, 2022 (3 updates tracked since 2022).

About Riverside Family Medicine NPPES

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

RIVERSIDE FAMILY MEDICINE (NPI 1780720813) is a healthcare organization registered as a family medicine in Madison, Tennessee and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through May 9, 2028 and lists Kimberly A Grenier, Office-billing Manager, as its authorized official.

NPPES Registry Identity

NPI1780720813
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRIVERSIDE FAMILY MEDICINE
Location Address1210 BRIARVILLE RD, BLDG FMadison, TN 37115-5141
Mailing Address1210 Briarville Rd, Bldg FMadison, TN 37115-5141 · (615) 860-0704 · Fax (615) 860-9882
Phone(615) 860-0704
Fax(615) 860-9882
Organization SubpartNo
Authorized OfficialKimberly A GrenierOffice-billing Manager · (615) 860-0704
Enumeration DateJanuary 29, 2007
Last NPPES UpdateDecember 19, 20243 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
✔ NPI 1780720813 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.
1210 BRIARVILLE RD, Madison, TN 37115
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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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Riverside Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Riverside Family Medicine, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Kenneth Dozier, MD
Family Practice
NPI 1184697898
1210 BRIARVILLE RD BLDG F
Madison, TN 37115
(615) 860-0708
✔ PECOS✔ Accepts MedicareSame address
Tony Freeman, MD
Family Practice
NPI 1285615278
1210 BRIARVILLE RD BLDG F
Madison, TN 37115
(615) 860-0704
✔ PECOS✔ Accepts MedicareSame address
Jennifer Jaris Weaver, APN, FNP-BC
Nurse Practitioner
NPI 1821012923
1210 BRIARVILLE RD BLDG F
Madison, TN 37115
(615) 860-0704
✔ PECOS✔ Accepts MedicareSame address
Peter Geleskie, M.D.
Family Practice
NPI 1609840131
1210 BRIARVILLE RD BLDG B
Madison, TN 37115
(615) 860-0704
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 44D0999367

Riverside Family Medicine · Madison, TN
Active · expires May 9, 2028
CLIA Number44D0999367
Laboratory TypePhysician Office
Certificate Effective DateMay 10, 2026
Certificate Expiration DateMay 9, 2028
Laboratory DirectorDr. Kenneth Dozier
Laboratory Phone(615) 860-0704
Laboratory LocationRiverside Family Medicine1210 Briarville Rd Bldg F, Madison, TN 37115
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Family Medicine's NPI number?

The NPI number for Riverside Family Medicine is 1780720813. It was assigned to this organization in the NPPES registry on January 29, 2007.

Where is Riverside Family Medicine located?

Riverside Family Medicine is located at 1210 Briarville Rd Bldg F, Madison, TN 37115. The listed phone number is (615) 860-0704.

What is Riverside Family Medicine's specialty?

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

Is Riverside Family Medicine enrolled in Medicare?

Yes. Riverside Family Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Riverside Family Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Riverside Family Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (3) and Nurse Practitioner (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Riverside Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0999367) is associated with this NPI, valid through May 9, 2028. 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 Family Medicine was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.