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Contact Information

RIVER VALLEY MEDICAL GROUP, LLC
4626 PROGRESS DR STE C
DAVENPORT, IA52807-3485
 Phone: 563-551-4200
 Fax: 563-441-9101
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for RIVER VALLEY MEDICAL GROUP, LLC

NPI # 1396408290
LBN Legal business name RIVER VALLEY MEDICAL GROUP, LLC
Authorized official RADHIKA KOLLA - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/18/2021
Last updated 06/23/2023 - About 3 years ago
Identifiers
IA Medicaid 1598744096
Other G81285 MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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