NPIMap

Organization Active NPI

John E. Rivera, M.D., P.C.

Doing business as Southington Family Medical Center

  • Family Medicine Physician
  • Milldale, CT
National Provider Identifier
1154387264
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
026829 Issued in CT
Legal business name
JOHN E. RIVERA, M.D., P.C.
Doing business as
Southington Family Medical Center
Practice address
1753 Meriden-Waterbury Rd
Milldale, CT 06467-0770
Phone
(860) 621-5554
Fax
(860) 621-3833
NPI assigned
Apr 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Edwin Rivera, M.D.NPI 1720044811
Title
Director
Phone
(860) 621-5554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 026829 CT Primary

Addresses

Primary practice location

1753 Meriden-Waterbury Rd
Milldale, CT 06467-0770

Mailing address

1753 Meriden-Waterbury Rd
Milldale, CT 06467-0770
Phone (860) 621-5554

Other identifiers 2

IdentifierTypeStateIssuer
026829OtherCTLIC-JOHN E. RIVERA, M.D.
042567OtherCTLIC-JOHN E. RIVERA, JR MD

Other names 1

  • Southington Family Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154387264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 MERIDEN-WATERBURY RD",
            "city": "MILLDALE",
            "state": "CT",
            "postal_code": "064670770",
            "telephone_number": "860-621-5554",
            "fax_number": "860-621-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 MERIDEN-WATERBURY RD",
            "city": "MILLDALE",
            "state": "CT",
            "postal_code": "064670770",
            "telephone_number": "860-621-5554",
            "fax_number": "860-621-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN E. RIVERA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-621-5554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "026829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-JOHN E. RIVERA, M.D.",
            "identifier": "026829",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC-JOHN E. RIVERA, JR MD",
            "identifier": "042567",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southington Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milldale, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.