Individual provider Active NPI

Mildred Rivera, NP

  • Adult Health Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1568486298
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
235057 Issued in GA
Practice address
11685 Alpharetta Hwy Ste 380
Roswell, GA 30076-4988
Phone
(770) 619-5100
Fax
(404) 250-8067
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN1867732 FL
Adult Health Nurse Practitioner 363LA2200X 235057 GA Primary

Addresses

Primary practice location

11685 Alpharetta Hwy Ste 380
Roswell, GA 30076-4988

Mailing address

11685 Alpharetta Hwy Ste 380
Roswell, GA 30076-4988
Phone (770) 619-5100

Other names 1

  • Ms. Mildred Rivera Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160426001369 GA Practitioner - Nurse Practitioner 8325029036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1357 Hembree Rd
Suite 130
Roswell, GA 30076-5723
Phone (678) 393-0012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN1867732FLMDAdult Health Nurse Practitioner
235057GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Oct 14, 2024 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Oct 14, 2024 Accepting new patients
Alpha Family Medicine Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

480 N Main St
Ste 202
Alpharetta, GA 30009
Phone (678) 619-1974

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1357 Hembree Rd
Ste 130
Roswell, GA 30076
Phone (678) 393-0012

11685 Alpharetta Hwy
Ste 380
Roswell, GA 30076
Phone (770) 475-7550

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9927/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ms_mrive217@landmarkhealth-direct.org

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1568486298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11685 ALPHARETTA HWY STE 380",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764988",
            "telephone_number": "770-619-5100",
            "fax_number": "404-250-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11685 ALPHARETTA HWY STE 380",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764988",
            "telephone_number": "770-619-5100",
            "fax_number": "404-250-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MILDRED",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN1867732",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "235057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILDRED",
            "last_name": "RIVERA",
            "prefix": "MS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.