Active NPI
Jorge E Rivera-Kolb, M.D.
- Hospice and Palliative Medicine (Emergency Medicine) Physician
- Conyers, GA
National Provider Identifier
1154542686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Emergency Medicine) Physician
- License
- 28360
- Practice address
- 1008 Meadow Springs Dr SW
Conyers, GA 30094-5768 - Phone
- (770) 648-6207
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Emergency Medicine) Physician | 207PH0002X | 28360 | GA | Primary |
Addresses
Primary practice location
1008 Meadow Springs Dr SW
Conyers, GA 30094-5768
Mailing address
1008 Meadow Springs Dr SW
Conyers, GA 30094-5768
Phone (770) 648-6207
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28360 | GA | MD | Hospice and Palliative Medicine (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Emergency Services, Inc. | Past | Accepting new patients | |
| Carter Emergency Physicians | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- NPI 1356377022
-
- Emergency Medicine Physician
- Booneville, MS
- NPI 1326007915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224806400000",
"number": "1154542686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 MEADOW SPRINGS DR SW",
"city": "CONYERS",
"state": "GA",
"postal_code": "300945768",
"telephone_number": "770-648-6207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 MEADOW SPRINGS DR SW",
"city": "CONYERS",
"state": "GA",
"postal_code": "300945768",
"telephone_number": "770-648-6207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA-KOLB",
"first_name": "JORGE",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2008-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207PH0002X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Hospice and Palliative Medicine",
"state": "GA",
"license": "28360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.