Active NPI
John S. Riveral, PA-C
- Physician Assistant
- Winston Salem, NC
National Provider Identifier
1740241165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100112
- Practice address
- 250 Charlois Blvd
Winston Salem, NC 27103-1508 - Phone
- (336) 718-1000
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100112 | NC | Primary |
Addresses
Primary practice location
250 Charlois Blvd
Winston Salem, NC 27103-1508
Mailing address
2000 Frontis Plaza Blvd Ste 200
Attn Novant Medical Group Forsyth
Winston Salem, NC 27103-5616
Phone (336) 277-2436
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1740241165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 FRONTIS PLAZA BLVD STE 200",
"address_2": "ATTN NOVANT MEDICAL GROUP FORSYTH",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035616",
"telephone_number": "336-277-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 CHARLOIS BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031508",
"telephone_number": "336-718-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERAL",
"first_name": "JOHN",
"middle_name": "S.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.