Enid Vidal-Rivera, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301066781 Issued in MI

Practice address

8392 Holly Rd
Grand Blanc, MI 48439-1867

Phone

(810) 694-9903

Fax

(810) 695-6644

NPI assigned

Aug 23, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1780791319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8392 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391867",
            "telephone_number": "810-694-9903",
            "fax_number": "810-695-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8392 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391867",
            "telephone_number": "810-694-9903",
            "fax_number": "810-695-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL-RIVERA",
        "first_name": "ENID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301066781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4189655",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "080B51127",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shiva Vaziri
• Lisa Vecore, C.R.N.A.
• Justin S Venable, CRNA
• Laura A Veverka
• Vibrant Rehab Services LLC
• Madison Anne Viera
• Tyler Marie Vincent
• Joshua Mack Vinova, MA, LLP
• Ellie Virgin, DO
• Francesca Amber Vitale, RN

• Family Medicine Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.