Individual provider Active NPI

Thomas Rivera, RPH

  • Pharmacist
  • Macomb, MI
National Provider Identifier
1306120381
Registry record updated Dec 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302029957 Issued in MI
Practice address
16450 26 Mile Rd
Macomb, MI 48042-1056
Phone
(586) 677-8730
NPI assigned
Oct 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302029957 MI Primary

Addresses

Primary practice location

16450 26 Mile Rd
Macomb, MI 48042-1056

Mailing address

50504 August Dr
Macomb, MI 48044-6315
Phone (586) 263-1443

Other practice location 1

47100 Hayes Rd
Macomb, MI 48044-5023
Phone (586) 532-8161

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302029957MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Sep 15, 2024 Accepting new patients
Kroger Co of Michigan PastSince Dec 15, 2019 Accepting new patients
Kroger Co of Michigan PastSince Dec 15, 2019 Accepting new patients
Walgreen Co Past 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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575763200000",
    "number": "1306120381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50504 AUGUST DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446315",
            "telephone_number": "586-263-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 26 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480421056",
            "telephone_number": "586-677-8730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47100 Hayes Rd",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480445023",
            "country_code": "US",
            "telephone_number": "586-532-8161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "THOMAS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302029957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2019; 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.