Veronica L Rivas, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT005433 Issued in OH

Practice address

1 White Falcon Dr
Mason, WV 25260-9615

Phone

(304) 773-5539

NPI assigned

Jun 18, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578093944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 W UNION ST APT 302D",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012350",
            "telephone_number": "623-696-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WHITE FALCON DR",
            "city": "MASON",
            "state": "WV",
            "postal_code": "252609615",
            "telephone_number": "304-773-5539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 W Camelback Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850173030",
            "country_code": "US",
            "telephone_number": "623-696-9720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "VERONICA",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT005433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohio Valley Physicians Inc
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• Robert Reed
• Derek W Rhodes, PHARMD
• Mary Charlene Roach
• Daisy Mae Robinson
• Robert G Tayengco, MD
• Earnest Leon Trent Jr.
• Wal-Mart Stores East LP

• All providers in Mason, WV
• Athletic Trainer in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.