Glenn Rivers Jr., RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN 9290432 Issued in FL

Practice address

10140 Deer Run Farms Rd
Fort Myers, FL 33966-1045

Phone

(239) 275-7356

NPI assigned

May 16, 2013

Sex

Male

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1649616632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 ORTIZ AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 DEER RUN FARMS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661045",
            "telephone_number": "239-275-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "GLENN",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9290432",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "575479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Rivera
• Martha Rivera, RBT
• Vanessa Rivera, CRNA
• Isara De la Caridad Rivero Garcia, RBT
• Dustin Ryan Rivers, MD
• Michelle Papadopoulos Rivers, MD
• Trey Allen Rivers
• Riverside Family Practice PA
• Riverwalk Anesthesia LLC
• Riverwalk ASC, LLC

• Registered Nurse in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.