Individual provider Active NPI

Jade Marie Rivera

  • Environmental Modification Occupational Therapy Assistant
  • El Paso, TX
National Provider Identifier
1316755119
Registry record updated Dec 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X
License
218663 Issued in TX
Practice address
5255 Woodrow Bean
El Paso, TX 79924-3832
Phone
(915) 206-4428
NPI assigned
Dec 25, 2024
Last updated
Dec 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapy Assistant 224ZE0001X 218663 TX Primary

Addresses

Primary practice location

5255 Woodrow Bean
El Paso, TX 79924-3832

Mailing address

12659 Fair Oaks CT
Horizon City, TX 79928-7497

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

State licenses

LicenseStateTypeSpecialty
218663TXMDEnvironmental Modification Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1735084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735084800000",
    "number": "1316755119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12659 FAIR OAKS CT",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799287497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 WOODROW BEAN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799243832",
            "telephone_number": "915-206-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JADE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-25",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "TX",
            "license": "218663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2024; 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.