Rebecca Rivera, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001839A Issued in IN

Practice address

7725 Highway 62 Ste 100
Charlestown, IN 47111

Phone

(812) 280-0413

Fax

(812) 280-0465

NPI assigned

Nov 7, 2013

Last updated

May 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Rebecca Bibb Former name

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spero Health of Indiana, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Indianapolis, IN
  • NPI 1962900183
  Medicare reassignment
• Spero Health of Ohio, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Zanesville, OH
  • NPI 1346748563
  Medicare reassignment
• FMMG LLC

  • Family Medicine Physician
  • New Albany, IN
  • NPI 1184912370
  NPD (past)

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1184053423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4917",
            "fax_number": "502-487-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 HIGHWAY 62 STE 100",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "47111",
            "telephone_number": "812-280-0413",
            "fax_number": "812-280-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001839A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007796",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MEDICARE",
            "identifier": "IN1189154",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD PA LICENSE NUMBER",
            "identifier": "PA08679",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BIBB",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adelaida Perez Castro, FNP-C
• Sara Poff
• Melissa Potter
• Jill Diane Rempe, R.PH.
• Rescare, Inc.
• Rivercrossing Independent and Assisted Living Community
• Dominique Robertson
• Karen Ann Roy, OTR
• Saint Catherine Hospital of Indiana LLC (Saint Catherine Regional Hospital)
• Saint Catherine Hospital of Indiana, LLC (d/b/a Saint Catherine Regional Hospital)

• Physician Assistant in Charlestown, IN
• Providers in Charlestown, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.