Individual provider Active NPI

Amy Katherine Rivas, MSN, RN, FNP-BC

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1356780464
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP122516 Issued in TX
Practice address
4101 22ND PL
Lubbock, TX 79410-1121
Phone
(806) 725-8000
Fax
(806) 723-6033
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP122516 TX Primary

Addresses

Primary practice location

4101 22ND PL
Lubbock, TX 79410-1121

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other practice location 1

3509 22nd St
Lubbock, TX 79410-1307
Phone (806) 799-7928

Other names 1

  • Amy Katherine Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140728000834 TX Practitioner - Nurse Practitioner 2365668308 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Covenant Medical Group CurrentSince Jul 1, 2023 Accepting new patients

Locations

4101 22nd Pl
Lubbock, TX 79410
Phone (806) 725-8000

3509 22nd St
Lubbock, TX 79410
Phone (806) 799-7928

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

1700 Cogdell Blvd
Snyder, TX 79549
Phone (325) 573-6374

Organizations & group practices 2

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1356780464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101121",
            "telephone_number": "806-725-8000",
            "fax_number": "806-723-6033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3509 22nd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101307",
            "country_code": "US",
            "telephone_number": "806-799-7928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "AMY",
        "middle_name": "KATHERINE",
        "credential": "MSN, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP122516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CAMPBELL",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.