Individual provider Active NPI

Vivian Rivera de Jesus, M.D.

  • General Practice Physician
  • Huntington, WV
National Provider Identifier
1285682716
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13603 Issued in PR
Practice address
1540 Spring Valley Drive
Huntington, WV 25704
Phone
(304) 429-6741
Fax
(304) 429-0262
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13603 PR Primary

Addresses

Primary practice location

1540 Spring Valley Drive
Huntington, WV 25704

Mailing address

1540 Spring Valley Drive
Huntington, WV 25704
Phone (304) 429-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317001024 WV Order and Referring Only - General PracticePractitioner - General Practice 0042261919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Health Preventive Services, CSP Past Accepting new patients
New Vision Medical Advisory Group, Inc. Past Accepting new patients
CRM Group Practice Past Accepting new patients
Salud Integral En la Montana, Inc. PastSince May 25, 2013 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1285682716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DRIVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25704",
            "telephone_number": "304-429-6741",
            "fax_number": "304-429-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DRIVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25704",
            "telephone_number": "304-429-6741",
            "fax_number": "304-429-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA DE JESUS",
        "first_name": "VIVIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.