Active NPI
Shaun Rivers, MSN RN
- Clinical Nurse Specialist
- Petersburg, VA
National Provider Identifier
1124482336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 0001146276
- Practice address
- 700 S Sycamore St
Suite 1
Petersburg, VA 23803-5802 - Phone
- (804) 324-5051
- NPI assigned
- Apr 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 0001146276 | VA | Primary |
Addresses
Primary practice location
700 S Sycamore St
Suite 1
Petersburg, VA 23803-5802
Mailing address
700 S Sycamore St
Suite 1
Petersburg, VA 23803-5802
Phone (804) 324-5051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001146276 | Other | VA | REGISTERED NURSE |
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001146276 | VA | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1124482336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 S SYCAMORE ST",
"address_2": "SUITE 1",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238035802",
"telephone_number": "804-324-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S SYCAMORE ST",
"address_2": "SUITE 1",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238035802",
"telephone_number": "804-324-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERS",
"first_name": "SHAUN",
"credential": "MSN RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "VA",
"license": "0001146276",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "0001146276",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.