Individual provider Active NPI

Kiara Griselle Rivera-Guevara, MD

  • Student in an Organized Health Care Education/Training Program
  • Texarkana, AR
National Provider Identifier
1447886650
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
5043132 Issued in AR
Practice address
3417 U of a Way
Texarkana, AR 71854-1419
Phone
(870) 779-6000
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5043132 PR
General Practice Physician 208D00000X 5043132 PR
Student in an Organized Health Care Education/Training Program 390200000X 5043132 AR Primary

Addresses

Primary practice location

3417 U of a Way
Texarkana, AR 71854-1419

Mailing address

3417 U of a Way
Texarkana, AR 71854-1419
Phone (870) 779-6000

Other practice location 1

Salida 21 Carr. 172 Urb. Turabo Gardens
Caguas, PR 00726
Phone (787) 743-3038

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250721001891 TX Order and Referring Only - Family PracticePractitioner - Family Practice 7810403540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5043132PRMDFamily Medicine Physician
5043132ARMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1447886650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 U OF A WAY",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541419",
            "telephone_number": "870-779-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 U OF A WAY",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541419",
            "telephone_number": "870-779-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Salida 21 Carr. 172 Urb. Turabo Gardens",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "00726",
            "country_code": "US",
            "telephone_number": "787-743-3038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA-GUEVARA",
        "first_name": "KIARA",
        "middle_name": "GRISELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "5043132",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "5043132",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": "5043132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.