Miguel Rivera III

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

26030725A Issued in IN

Practice address

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Phone

(260) 266-1000

NPI assigned

Jun 24, 2024

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

State licenses

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1699519793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 BONTERRA BLVD APT 10-202",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468450067",
            "telephone_number": "915-497-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MIGUEL",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "71369",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26030725A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Rae Ritter, NP
• Robert Ritter
• Emily Ritzert, PA-C
• Edgardo D Rivera-Rivera, M.D.
• Erin Eileen Rivera, PHD, CNS, APRN, BC
• Alexah K Rivers, LCSW
• Riverside Trauma Services
• Riverview Hospital
• Riverview Hospital
• Arnel Rizvic

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.