Caelan River Scott Kivette, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-04332 Issued in NC

Practice address

3140 Rowena Ave
Durham, NC 27703-4447

Phone

(860) 918-0020

NPI assigned

Aug 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susanna Scott Kivette Former name

Medicare fee-for-service enrollment

Enrolled in NC, NY, NJ, VA4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susanna.kivette.1@22378.direct.athenahealth.com
• Direct secure messaging: caelanriver.kivette@217526021193732.direct.elationemr.com

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.

• Western North Carolina Community Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1780801050
  Medicare reassignment
• Ophelia Medical Group FL, P.a.

  • Addiction Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1588244750

  VA

  Medicare reassignment
• Western North Carolina Community Health Services, Inc.

  • Community Health Clinic/Center
  • Asheville, NC
  • NPI 1043392921
  NPD
• Western North Carolina Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, NC
  • NPI 1790402345
  NPD
• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Burnsville, NC
  • NPI 1568914521
  NPD (past)
• Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Burnsville, NC
  • NPI 1831799667
  NPD (past)
• Marsha Medical Group of Ca, P.C.

  • Adult Medicine Physician
  • Los Angeles, CA
  • NPI 1811683311
  NPD (past)

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1336573633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 ROWENA AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034447",
            "telephone_number": "860-918-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 ROWENA AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034447",
            "telephone_number": "860-918-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVETTE",
        "first_name": "CAELAN RIVER",
        "middle_name": "SCOTT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031107-01",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "KIVETTE",
            "middle_name": "SCOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Kisslo, M.D.
• Susan Fleming Kistler, GNP
• Joseph Musyoka Kiswii
• Veraprapas Kittipibul, MD
• Joseph Kivett, PMHNP-BC
• Kaitlyn Kivi, RD, LDN
• Danielle Klaseus, RD
• Christopher Klasson
• Susan S. Kleckley, LCSW
• Klein Speech and Language Therapy, PLLC

• Medical Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.