Stacia A Rivers, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

46839 Issued in MN

Practice address

2165 White Bear Ave - Mail Stop 31600a
Healthpartners Maplewood Clinic
Maplewood, MN 55109

Phone

(651) 523-9800

Fax

(651) 523-9801

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1467569632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-523-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVE - MAIL STOP 31600A",
            "address_2": "HEALTHPARTNERS MAPLEWOOD CLINIC",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-523-9800",
            "fax_number": "651-523-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "STACIA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "46839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450916",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Frances Richter
• Lori A Ricke, M.D.
• Rachel Jo Riesgraf, MS, CGC
• Jessica Danielle Riggs, PSYD
• Leslie Denise Ritenour
• Shari Robbins, MD
• Robert J Sevenich M.D.,J.D.,P.a.
• Tyller Robert
• Kelly Roberto, FNP-C
• Chris A Rodahl

• Pediatrics Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.