Individual provider Active NPI

Lorraine Rivero, NP

  • Nurse Practitioner
  • Shaw AFB, SC
National Provider Identifier
1265901847
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.21613 Issued in SC
Practice address
420 Polifka Dr
Shaw AFB, SC 29152-5100
Phone
(843) 895-6449
NPI assigned
Nov 13, 2018
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.21613 SC Primary

Addresses

Primary practice location

420 Polifka Dr
Shaw AFB, SC 29152-5100

Mailing address

420 Polifka Dr
Shaw AFB, SC 29152-5100
Phone (803) 895-6356

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.21613SCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1265901847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "843-895-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "LORRAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "APN.21613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaw AFB, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.