Active NPI
Nancy Jeanne Rivera, OTR
- Occupational Therapist
- Wylie, TX
National Provider Identifier
1700386349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 111431
- Practice address
- 18 San Juan Cir
Wylie, TX 75098-8215 - Phone
- (631) 523-3039
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 111431 | TX | Primary |
Addresses
Primary practice location
18 San Juan Cir
Wylie, TX 75098-8215
Mailing address
311 Amber LN
Nevada, TX 75173-0122
Phone (631) 523-3039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111431 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1700386349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 AMBER LN",
"city": "NEVADA",
"state": "TX",
"postal_code": "751730122",
"telephone_number": "631-523-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 SAN JUAN CIR",
"city": "WYLIE",
"state": "TX",
"postal_code": "750988215",
"telephone_number": "631-523-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "NANCY",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "111431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wylie, TX
Sources for this page
- 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.