Active NPI
Michelle Lorraine Rivera, M.D.
- Diagnostic Radiology Physician
- Charlotte, NC
National Provider Identifier
1447429352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 9700729
- Practice address
- 3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-4864 - Phone
- (704) 332-1291
- Fax
- (704) 332-5206
- NPI assigned
- Feb 25, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 9700729 | NC | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 28521 | SC |
Addresses
Primary practice location
3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-4864
Mailing address
PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231025001868 | FL | Practitioner - Diagnostic Radiology | 0244315471 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28521 | SC | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates of Hollywood, Inc. | Diagnostic Radiology | Past | Accepting new patients |
| Mori Bean and Brooks Inc | Diagnostic Radiology | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Tampa, FL
- NPI 1093782070
-
- Diagnostic Radiology Physician
- South Miami, FL
- NPI 1992191928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1447429352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 221249",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282221249",
"telephone_number": "704-332-1291",
"fax_number": "704-332-5206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3623 LATROBE DR",
"address_2": "SUITE 216",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282114864",
"telephone_number": "704-332-1291",
"fax_number": "704-332-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MICHELLE",
"middle_name": "LORRAINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-25",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "9700729",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "28521",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.