Stephanie Marie Altick Rivera, APRN-CNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

315910 Issued in OH

Practice address

2960 Mack Rd Ste 200
Fairfield, OH 45014-5300

Phone

(513) 421-3494

Fax

(513) 867-3241

NPI assigned

Feb 2, 2024

Last updated

Oct 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Five Rivers Health CentersGroup PAC ID 9335300904, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1669143061
  Medicare reassignment Care Compare group
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Surgery Physician
  • Blue Ash, OH
  • NPI 1154942795
  Medicare reassignment NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1053600775
  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Xenia, OH
  • NPI 1083501415
  NPD
• Five Rivers Health Centers

  dba Five Rivers Health Centers at St Vincent De Paul

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1891302188
  NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  dba Mercy Health- Kyles Station Orthopedic and Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Liberty TWP, OH
  • NPI 1730993270
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1487417374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-421-3494",
            "fax_number": "513-867-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-421-3494",
            "fax_number": "513-867-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3533 Southern Blvd Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291267",
            "country_code": "US",
            "telephone_number": "937-395-8556",
            "fax_number": "937-395-6376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4777 E Galbraith Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452362725",
            "country_code": "US",
            "telephone_number": "513-686-5890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTICK RIVERA",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "315910",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OH",
            "license": "APRN.CNP.0035809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "saltickrivera4575@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alliance Physicians, Inc. (Village Green Primary Care)
• Ally Angel Care LLC
• Almas Family Adhc
• Alpha & Omega Healthcare LLC
• Kathleen A. Alter, M.D.
• Always Goodday LLC
• Always Service Center LLC (Always Service Center)
• Elizabeth Kumbong Amaazee
• Ofori Amannfo
• Amazing Grace Care (Emilie Sandra Longsi Nguebong)

• Acute Care Nurse Practitioner in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Acute Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.
• 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.