Stephane Rivard

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1500 Oglethorpe Ave Ste 200C
Athens, GA 30606-2165

Phone

(706) 389-3875

NPI assigned

Apr 4, 2024

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: srivard3343390@direct.trinity-health.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 4, 2024.

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1417709262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "706-389-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 200C",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062165",
            "telephone_number": "706-389-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "STEPHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Athens, GA
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.