Kelsey Eaves Rivenburgh

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

117 NE 51St St
Oak Island, NC 28465-5118

Phone

(910) 777-4207

NPI assigned

Mar 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD

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

• Pitt County Memorial Hospital Inc

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1497513873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 NE 51ST ST",
            "city": "OAK ISLAND",
            "state": "NC",
            "postal_code": "284655118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NE 51ST ST",
            "city": "OAK ISLAND",
            "state": "NC",
            "postal_code": "284655118",
            "telephone_number": "910-777-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVENBURGH",
        "first_name": "KELSEY",
        "middle_name": "EAVES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paragon Outpatient Rehabilitation Services, LLC
• Kerry Lee Partis, MD
• Belinda Owen Phillips, RN IBCLC
• Chris Phillips, COTA/L
• Presbyterian Regional Healthcare Corp.
• Amanda L Shirley, FNP-C
• Hailey Lynn la Rocque Sparacino, DO
• Jaime Staron, M.A., CCC-SLP
• Justin Randall Stiffler, L. AC.
• Laura C Strickland, D.O.

• Physician Assistant in Oak Island, NC
• Providers in Oak Island, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.