Kelly Rivera, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75388 Issued in CA

Practice address

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Phone

(872) 810-2133

NPI assigned

Oct 2, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800
  NPD

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1780011932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6134 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344115",
            "telephone_number": "415-546-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "872-810-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 18th St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941102109",
            "country_code": "US",
            "telephone_number": "415-546-6756 x387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R. Scott Ritchhart, DMD
• Stephanie M. Ritter, RNFA
• Cal Riutta, MD
• Amanda Lynn Riva, MSW
• Brent Riva, CRNA
• Nicolas Paul Rivera, CRNA
• Rex Rizaldo, APRN
• Kevin T Robbins, M.D.
• Robert C Russell M D S C
• Emily C Roberts, MSW

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.