Individual provider Active NPI

Jisselle Anai Rivera, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Corpus Christi, TX
National Provider Identifier
1477284628
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118274 Issued in TX
Practice address
3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone
(361) 694-5000
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 118274 TX Primary

Addresses

Primary practice location

3533 S Alameda St
Corpus Christi, TX 78411-1721

Mailing address

101 Uhland Rd Ste 112
San Marcos, TX 78666-6681
Phone (512) 396-0872

Other practice location 1

101 Uhland Rd Ste 112
San Marcos, TX 78666-6681
Phone (512) 396-0872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240902000228 TX Practitioner - Qualified Speech Language Pathologist 3274072442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
118274TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidtherapy, PLLC Speech-Language Pathologist PastSince Jun 1, 2022 Accepting new patients
Driscoll Children'S Hospital 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.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1477284628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 UHLAND RD STE 112",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666681",
            "telephone_number": "512-396-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Uhland Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786666681",
            "country_code": "US",
            "telephone_number": "512-396-0872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JISSELLE",
        "middle_name": "ANAI",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.