Individual provider Active NPI

Jessica Rivera, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bozeman, MT
National Provider Identifier
1013796614
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-239192 Issued in MT
Practice address
676 S Ferguson Ave Ste 1
Bozeman, MT 59718-1951
Phone
(602) 791-3411
Fax
(602) 297-6964
NPI assigned
Sep 25, 2023
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61539312 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 298068 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-239192 MT Primary

Addresses

Primary practice location

676 S Ferguson Ave Ste 1
Bozeman, MT 59718-1951

Mailing address

1106 W Park St
Suite 20 PMB 428
Livingston, MT 59047-2955
Phone (602) 791-3411

Other practice location 1

8101 W Louise Dr
Peoria, AZ 85383-2185
Phone (602) 327-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
298068AZMDPsychiatric/Mental Health Nurse Practitioner
APRN-239192MTMDPsychiatric/Mental Health Nurse Practitioner
AP61539312WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1013796614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 W PARK ST",
            "address_2": "SUITE 20 PMB 428",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590472955",
            "telephone_number": "602-791-3411",
            "fax_number": "602-297-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 S FERGUSON AVE STE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597181951",
            "telephone_number": "602-791-3411",
            "fax_number": "602-297-6964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 W Louise Dr",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853832185",
            "country_code": "US",
            "telephone_number": "602-327-2421",
            "fax_number": "602-297-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61539312",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "298068",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "APRN-239192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.