Stacey Lynn Rivet, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704225948 Issued in MI

Practice address

100 Michigan St NE
MC 117
Grand Rapids, MI 49503-2560

Phone

(616) 267-0118

Fax

(616) 267-0090

NPI assigned

Aug 19, 2006

Last updated

Feb 22, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Stacey Lynn Mahoney Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srivet1065158@direct.hfhs.org

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.

• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group NPD
• Degara App, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1265976971

  Nurse Practitioner

  Medicare reassignment NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Regional Children's Center

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Insight Urgent Care PC

  dba Insight Urgent Care

  • Urgent Care Clinic/Center
  • Flint, MI
  • NPI 1548895550
  Medicare reassignment NPD
• McLaren Hospital Group

  • Emergency Medicine Physician
  • Flint, MI
  • NPI 1942026174
  Medicare reassignment NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066

  Nurse Practitioner

  Medicare reassignment NPD
• Capital Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lansing, MI
  • NPI 1295794717
  NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Urgent Care

  • Urgent Care Clinic/Center
  • East Lansing, MI
  • NPI 1477509313
  NPD
• Insight Urgent Care PC

  • Durable Medical Equipment & Medical Supplies
  • Flint, MI
  • NPI 1457079584
  NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1659486041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6794",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 117",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-267-0118",
            "fax_number": "616-267-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVET",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704225948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH ADVANTAGE",
            "identifier": "1057817",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-COMMERCIAL",
            "identifier": "1057817",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PLUS BLUE",
            "identifier": "0N55170019",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5008772580",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00766372",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-MEDICAID",
            "identifier": "1057817",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "MAHONEY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Christian Rivera, LMSW
• Samantha Jean Rivera, M.S. CCC-SLP
• John Rivero
• Riverside Psychiatric Services PLLC
• Riverwood Family Medicine PC
• Bridget Ann Rizik
• Christopher Rizik
• John Paul Rizik, DO
• Syed Ali Rizvi, M.D.
• Atif Rizwan, MD

• Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.