Individual provider Active NPI

Teresa Rivera

  • Speech-Language Pathologist
  • Mandan, ND
National Provider Identifier
1124449467
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1265 Issued in ND
Practice address
901 Division St NW
Mandan, ND 58554-1641
Phone
(701) 751-6500
NPI assigned
Jan 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1265 ND Primary

Addresses

Primary practice location

901 Division St NW
Mandan, ND 58554-1641

Mailing address

505 1/2 Oth St NW
Mandan, ND 58554
Phone (701) 751-6500

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
1265NDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1124449467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 1/2 OTH ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "58554",
            "telephone_number": "701-751-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DIVISION ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541641",
            "telephone_number": "701-751-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.