Individual provider Active NPI

Jasmine Anne Rivera, PTA

  • Physical Therapy Assistant
  • Bethlehem, PA
National Provider Identifier
1396996807
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE007750 Issued in PA
Practice address
2029 Westgate Dr
Bethlehem, PA 18017-7412
Phone
(610) 861-0100
NPI assigned
Oct 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE007750 PA Primary

Addresses

Primary practice location

2029 Westgate Dr
Bethlehem, PA 18017-7412

Mailing address

2029 Westgate Dr
Bethlehem, PA 18017-7412
Phone (610) 861-0100

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
TE007750PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1396996807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 WESTGATE DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177412",
            "telephone_number": "610-861-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 WESTGATE DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177412",
            "telephone_number": "610-861-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JASMINE",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE007750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.