Active NPI
Eduardo Alfredo Rivas - Pardo, M.D.
- Anesthesiology Physician
- Huntington, WV
National Provider Identifier
1508948191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 12809
- Practice address
- 1340 Hal Greer Blvd
Huntington, WV 25701-3800 - Phone
- (205) 322-1808
- Fax
- (205) 322-1851
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 12809 | WV | Primary |
Addresses
Primary practice location
1340 Hal Greer Blvd
Huntington, WV 25701-3800
Mailing address
PO Box 714960
Columbus, OH 43271-4960
Phone (205) 322-1808
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001720969 | Other | WV | BCBS |
| 0775399 | Medicaid | OH | |
| P00249933 | Other | PALMETTO GBA-RR MEDICARE | |
| 1027242 | Other | WV | WORKERS' COMP |
| 0057987000 | Medicaid | WV | |
| 64697931 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12809 | WV | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415750400000",
"number": "1508948191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 714960",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432714960",
"telephone_number": "205-322-1808",
"fax_number": "205-322-1851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 HAL GREER BLVD",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257013800",
"telephone_number": "205-322-1808",
"fax_number": "205-322-1851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVAS - PARDO",
"first_name": "EDUARDO",
"middle_name": "ALFREDO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2014-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WV",
"license": "12809",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "001720969",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0775399",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA-RR MEDICARE",
"identifier": "P00249933",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS' COMP",
"identifier": "1027242",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0057987000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64697931",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.