Carlos Miguel Rivera Jr.
Individual provider Active NPI Athletic Trainer · Pembroke, NC
NPI 1114550290 · NPPES record last updated Feb 18, 2020
Key facts
- NPI
- 1114550290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1 University Rd
Pembroke, NC 28372-8699 - Phone
- (910) 859-0732
- NPI assigned
- Feb 18, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
1 University Rd
Pembroke, NC 28372-8699
Mailing address
331 Bell St TRLR 35
Wilmington, NC 28401-7623
Other providers in Pembroke, NC
- Roshni Lal Ramirez
- Danielle Nicole Reagan
- Redeemed Hope Counseling
- Adia Resha Redfearn
- Porsha L Revels
- Shana Roark
- Robeson Health Care Corporation
- Robeson Health Care Corporation
- Robeson Health Care Corporation
- Robeson Health Care Corporation
All providers in Pembroke, NC · Athletic Trainer in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.