Individual provider Active NPI

Carmelo Rivera, LPN

  • Licensed Practical Nurse
  • Humacao, PR
National Provider Identifier
1164615852
Registry record updated Aug 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
21444 Issued in PR
Practice address
355 Calle Font Martelo
Humacao, PR 00791-3249
Phone
(787) 852-0768
NPI assigned
Aug 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 21444 PR Primary

Addresses

Primary practice location

355 Calle Font Martelo
Humacao, PR 00791-3249

Mailing address

355 Calle Font Martelo
Humacao, PR 00791-3249
Phone (787) 852-0768

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
21444PRMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188000000000",
    "number": "1164615852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CALLE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913249",
            "telephone_number": "787-852-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CALLE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913249",
            "telephone_number": "787-852-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "CARMELO",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-25",
        "last_updated": "2007-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PR",
            "license": "21444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2007; 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.