Individual provider Active NPI

Therese P. Rivard, P.A.

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1245418722
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03434 Issued in NC
Practice address
2800 Blue Ridge Rd Ste 201
Raleigh, NC 27607-6477
Phone
(919) 784-7110
Fax
(919) 784-7111
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 180313 NC
Surgical Physician Assistant 363AS0400X 1980 MA
Surgical Physician Assistant 363AS0400X 055.0031325 VT
Physician Assistant 363A00000X 0010-03434 NC Primary

Addresses

Primary practice location

2800 Blue Ridge Rd Ste 201
Raleigh, NC 27607-6477

Mailing address

2800 Blue Ridge Rd Ste 201
Raleigh, NC 27607-6477
Phone (919) 784-7110

Other names 1

  • Therese Piacente Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trivard8503@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VT2 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

Enrollment IDStateProvider typePAC IDDetails
I20120326000404 NC Practitioner - Physician Assistant 2769642933 Reassigns benefits to 1 organization
I20170419001834 VT Practitioner - Physician Assistant 2769642933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

2800 Blue Ridge Rd
Raleigh, NC 27607-6477

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1980MAMDChiropractor
180313NCMDPhysician Assistant
055.0031325VTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Mar 18, 2017 Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: trivard8503@direct.unc.nchie.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1245418722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076477",
            "telephone_number": "919-784-7110",
            "fax_number": "919-784-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076477",
            "telephone_number": "919-784-7110",
            "fax_number": "919-784-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "THERESE",
        "middle_name": "P.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "180313",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1980",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VT",
            "license": "055.0031325",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trivard8503@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2800 Blue Ridge Rd Ste 201",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESE",
            "last_name": "PIACENTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.