Laurette Elizabeth Rivers, APRN, CPNP-PC, CLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2275 Issued in HI

Practice address

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002

Phone

(580) 354-5500

Fax

(580) 354-5511

NPI assigned

Apr 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lawton Indian Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1760489223

  TX

  Medicare reassignment NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1205254752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5500",
            "fax_number": "580-354-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5500",
            "fax_number": "580-354-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "LAURETTE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APRN, CPNP-PC, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "92722",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "85067",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "HI",
            "license": "2275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Marie Rivera, PHARM D
• Maria R. Rivera, M.D.
• Reyna Rivera, B.S.
• Kameyce Javell Rivers-Leader
• Anastacia Rosetta Rivers, LPN
• Alicia Roa
• Roadback Incorporated
• Roadback, Inc.
• Minda Unidad Roan, MD
• Robert L Miracle, DMD, PC

• Pediatric Nurse Practitioner in Lawton, OK
• Providers in Lawton, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.