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RIVERWOOD FAMILY MEDICINE PC
NPI 1972677656
Family Medicine in Grand Rapids, MI

Active since November 17, 2006
3299 CLEAR VISTA CT NE, SUITE C, GRAND RAPIDS, MI 49525(616) 361-1200(616) 361-2198 Get Directions Write a Review

NPPES record last updated: April 21, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Riverwood Family Medicine Pc NPPES

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

RIVERWOOD FAMILY MEDICINE PC (NPI 1972677656) is a healthcare organization registered as a family medicine in Grand Rapids, Michigan and active in the NPI registry since November 2006. The organization lists Randall N Clark, Vice President, as its authorized official.

NPPES Registry Identity

NPI1972677656
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRIVERWOOD FAMILY MEDICINE PC
Location Address3299 CLEAR VISTA CT NE, SUITE CGrand Rapids, MI 49525-9477
Mailing Address3299 Clear Vista Ct Ne, Suite CGrand Rapids, MI 49525-9477 · (616) 361-1200 · Fax (616) 361-2198
Phone(616) 361-1200
Fax(616) 361-2198
Organization SubpartNo
Authorized OfficialRandall N ClarkVice President · (616) 361-1178
Enumeration DateNovember 17, 2006
Last NPPES UpdateApril 21, 2011
✔ NPI 1972677656 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.
3299 CLEAR VISTA CT NE, Grand Rapids, MI 49525
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Other Identifiers 2

Medicare ID-Type Unspecified0D14848MI · Group Number
Other080D148480MI · Bcbs Group Number

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Riverwood Family Medicine PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Randall Clark, MD
Family Practice
NPI 1063573319
3980 CHICAGO DR SW STE 200
Grandville, MI 49418
(616) 381-5181
✔ PECOS13 mi

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

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 Riverwood Family Medicine PC's NPI number?

The NPI number for Riverwood Family Medicine PC is 1972677656. It was assigned to this organization in the NPPES registry on November 17, 2006.

Where is Riverwood Family Medicine PC located?

Riverwood Family Medicine PC is located at 3299 Clear Vista Ct NE Suite C, Grand Rapids, MI 49525. The listed phone number is (616) 361-1200.

What is Riverwood Family Medicine PC's specialty?

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

Is Riverwood Family Medicine PC enrolled in Medicare?

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

How many clinicians bill Medicare through Riverwood Family Medicine PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Riverwood Family Medicine PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Riverwood Family Medicine PC was last updated on April 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.