Jessica Marie Rivera, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3018599 Issued in KY

Practice address

2000 Ring Rd
Elizabethtown, KY 42701-9454

Phone

(502) 694-4820

NPI assigned

Oct 28, 2021

Last updated

Jan 25, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1770247355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427020340",
            "telephone_number": "270-506-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019454",
            "telephone_number": "502-694-4820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 DuPont Cir Ste 210",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074847",
            "country_code": "US",
            "telephone_number": "502-694-4820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018599",
            "primary": true
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "KY",
            "license": "1141654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.