| Rivertown Psychiatry Pc | |
|
6003 Veterans Pkwy Columbus GA 31909-6200 | |
| (706) 223-1933 | |
| (706) 223-1934 |
| Full Name | Rivertown Psychiatry Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6003 Veterans Pkwy, Columbus, Georgia |
| Authorized Official Name and Position | Kaizad P Shroff (OWNER) |
| Authorized Official Contact | 7062231933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivertown Psychiatry Pc 6003 Veterans Pkwy Columbus GA 31909-6200 Ph: (706) 223-1933 | Rivertown Psychiatry Pc 6003 Veterans Pkwy Columbus GA 31909-6200 Ph: (706) 223-1933 |
| NPI Number | 1023362852 |
|---|---|
| Provider Enumeration Date | 10/31/2012 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 1153575410 |
|---|---|
| Medicare Enrollment ID | O20130214000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023362852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 62002 (Georgia) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 62002 (Georgia) | Secondary |
| Provider Name | Kaizad P Shroff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912164765 PECOS PAC ID: 7416097795 Enrollment ID: I20091217000208 |
| Provider Name | Josue F Becerra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639195084 PECOS PAC ID: 9830137116 Enrollment ID: I20100202000183 |
| Provider Name | Rizwan Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134340052 PECOS PAC ID: 3375677248 Enrollment ID: I20100813000457 |
| Provider Name | Mia M Galioto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225011307 PECOS PAC ID: 8527963560 Enrollment ID: I20111121000198 |
| Provider Name | Flora Ida Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699052753 PECOS PAC ID: 2668648734 Enrollment ID: I20111221000069 |
| Provider Name | Lesley D Teel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659612299 PECOS PAC ID: 7012156433 Enrollment ID: I20130615000145 |
| Provider Name | Kimberly Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306171129 PECOS PAC ID: 2163643925 Enrollment ID: I20141020000836 |
| Provider Name | Eddie Truelove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023042298 PECOS PAC ID: 5799708871 Enrollment ID: I20150423001708 |
| Provider Name | Elaine N Shirah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326590282 PECOS PAC ID: 6103104898 Enrollment ID: I20161101000513 |
| Provider Name | Stephanie N Hickerson-jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275946402 PECOS PAC ID: 3779806252 Enrollment ID: I20170501001673 |
| Provider Name | Jennifer Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255789996 PECOS PAC ID: 8628335023 Enrollment ID: I20171120000770 |
| Provider Name | Debora A Lamonica |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821045402 PECOS PAC ID: 3779591755 Enrollment ID: I20180427001861 |
| Provider Name | Sher Schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376631192 PECOS PAC ID: 9638426497 Enrollment ID: I20180725000545 |
| Provider Name | Kellie Hoad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639671555 PECOS PAC ID: 8729338405 Enrollment ID: I20180829003651 |
| Provider Name | Brittany Montescelis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063902260 PECOS PAC ID: 9638506181 Enrollment ID: I20200224001819 |
| Provider Name | Elizabeth Ann Foxall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720162043 PECOS PAC ID: 2264833458 Enrollment ID: I20210625000020 |
| Provider Name | Venita T Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972131324 PECOS PAC ID: 3274931233 Enrollment ID: I20211006001981 |
| Provider Name | Ebony Y Arceneaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841927142 PECOS PAC ID: 7214311786 Enrollment ID: I20220901000549 |
| Provider Name | Sandra Madaris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346796307 PECOS PAC ID: 1052652740 Enrollment ID: I20230601000190 |
| Provider Name | Demetria Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255020178 PECOS PAC ID: 9931567104 Enrollment ID: I20230620002658 |
| Provider Name | Kristina Vincent |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184884892 PECOS PAC ID: 2769843309 Enrollment ID: I20230731001088 |
| Provider Name | Kendra Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306546957 PECOS PAC ID: 5698138170 Enrollment ID: I20230831000593 |
| Provider Name | Leslie Walters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831210137 PECOS PAC ID: 3870942675 Enrollment ID: I20231205002533 |
| Provider Name | Kimberly Seldon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134699895 PECOS PAC ID: 0749631810 Enrollment ID: I20240112003122 |
| Provider Name | Kimby Graves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104054600 PECOS PAC ID: 0244681310 Enrollment ID: I20240112003286 |
| Provider Name | Delilah Hardin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285216424 PECOS PAC ID: 8820449903 Enrollment ID: I20240112003512 |
| Provider Name | Megan Mooney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831596626 PECOS PAC ID: 6406208164 Enrollment ID: I20240118000227 |
| Provider Name | Laurie Miller-ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407342512 PECOS PAC ID: 8426401399 Enrollment ID: I20240126001571 |
| Provider Name | David Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952604183 PECOS PAC ID: 1759724941 Enrollment ID: I20240205002025 |
| Provider Name | Myriam Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245943562 PECOS PAC ID: 5597108266 Enrollment ID: I20240209000871 |
| Provider Name | Katie Durham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689910333 PECOS PAC ID: 6800230707 Enrollment ID: I20240220000278 |
| Provider Name | Cathy Nail |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801483243 PECOS PAC ID: 6305282906 Enrollment ID: I20240306000090 |
| Provider Name | Folayan Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467826859 PECOS PAC ID: 1557707015 Enrollment ID: I20240307001043 |
| Provider Name | Tiffany Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851156806 PECOS PAC ID: 6901247501 Enrollment ID: I20240514002579 |
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