RIVERSIDE PODIATRY CLINIC INC. NPI 1780605055

NPI Information

  • NPI: 1780605055
  • Provider Name: RIVERSIDE PODIATRY CLINIC, INC.
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • Address: 1900 W KEM RD
    MARION, IN
    ZIP 46952
  • Phone: (765) 664-0107

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NPI Details

RIVERSIDE PODIATRY CLINIC, INC. is a podiatrist in Marion, IN. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. RIVERSIDE PODIATRY CLINIC, INC. NPI is 1780605055. The provider is registered as an organization entity type.

The provider's business location address is:

1900 W KEM RD
MARION, IN
ZIP 46952-548
Phone: (765) 664-0107
Fax: (765) 664-6541

The provider's authorized official is Gary Lynn Adsit .
The authorized official title is Owner and has the following contact phone number (765) 664-0107.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 6/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2213E00000XPodiatrist07000307INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000083983OTHERINDIANABLUE CROSS BLUE SHIELD
2293090MEDICARE ID-TYPE UNSPECIFIEDINDIANA
3=========OTHERINDIANATRICARE
4DR6511OTHERINDIANARR MEDICARE
52551650001MEDICARE NSCINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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