Individual provider Active NPI

Mariette Nicole Pena Rivera, PHARMD

  • Pharmacist
  • New Orleans, LA
National Provider Identifier
1770293946
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.024628 Issued in LA
Practice address
4110 Gen Degaulle Dr
New Orleans, LA 70131-8231
Phone
(504) 433-3297
NPI assigned
Nov 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.024628 LA Primary

Addresses

Primary practice location

4110 Gen Degaulle Dr
New Orleans, LA 70131-8231

Mailing address

4110 Gen Degaulle Dr
New Orleans, LA 70131-8231
Phone (504) 433-3297

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PST.024628LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1770293946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 GEN DEGAULLE DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701318231",
            "telephone_number": "504-433-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 GEN DEGAULLE DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701318231",
            "telephone_number": "504-433-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA RIVERA",
        "first_name": "MARIETTE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.024628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.