Individual provider Active NPI

Rebecca Regina Rivera, PT

  • Physical Therapist
  • Mayfield, KY
National Provider Identifier
1487169074
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00002565 Issued in KY
Practice address
401 Indiana Ave
Mayfield, KY 42066-1766
Phone
(270) 247-0200
NPI assigned
Dec 5, 2017
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00002565 KY Primary

Addresses

Primary practice location

401 Indiana Ave
Mayfield, KY 42066-1766

Mailing address

401 Indiana Ave
Mayfield, KY 42066-1766
Phone (270) 247-0200

Other names 1

  • Jenny Rivera Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220308000466 KY Practitioner - Physical Therapist in Private Practice 2961896972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caldwell County Hospital, IncGroup PAC ID 0749275014, 25 clinicians

Practice addresses (Care Compare)

550 Hwy 62 W
Suite 400
Princeton, KY 42445-2435
Phone (270) 365-9599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00002565KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Caldwell County Hospital, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Caldwell County Hospital, Inc Single Specialty Current Accepting new patients
Caldwell County Hospital, Inc Single Specialty CurrentSince Jan 1, 2022 Accepting new patients

Locations

100 Medical Center Dr
Princeton, KY 42445
Phone (270) 365-0300

320 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-0320

550 US Highway 62 W
Ste 400
Princeton, KY 42445
Phone (270) 365-0300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIDFCD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1487169074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 INDIANA AVE",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661766",
            "telephone_number": "270-247-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 INDIANA AVE",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661766",
            "telephone_number": "270-247-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "REBECCA",
        "middle_name": "REGINA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "00002565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "RIVERA",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mayfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.