Active NPI
Juan Rivera, DPT
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1437693553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5145
- Practice address
- 921 Ne13Th St
Oklahoma City, OK 73104 - Phone
- (405) 456-3927
- NPI assigned
- Dec 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 53679 | ||
| Physical Therapist | 225100000X | 5145 | OK | Primary |
Addresses
Primary practice location
921 Ne13Th St
Oklahoma City, OK 73104
Mailing address
18700 Vivo Dr
Edmond, OK 73012-2635
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5145 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583712000000",
"number": "1437693553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18700 VIVO DR",
"city": "EDMOND",
"state": "OK",
"postal_code": "730122635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 NE13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73104",
"telephone_number": "405-456-3927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JUAN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-08",
"last_updated": "2020-03-09",
"certification_date": "2020-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": "53679",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.