Ian Matthew Rivera, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

61853 Issued in GA

Practice address

300 W Hospital Rd
Fort Gordon, GA 30905-5741

Phone

(706) 787-7665

Fax

(706) 787-2326

NPI assigned

Aug 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1780830331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-7665",
            "fax_number": "706-787-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-7665",
            "fax_number": "706-787-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "IAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "61853",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "61853",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780830331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Elaine Rhodes, CTRS
• Maria Teresa Richard, PAC
• Monica Salinas Richards, LPN
• Daniel Richardson, R.N.
• Retaunda Monique Riley, PA-C
• Marilyn A Rivera, RPH
• Natalia R. Rivera, LCSW
• David Bentley Roberson, DMD
• Emily Ann Robinson, APRN
• Michelle A Roda, DO

• Nephrology Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.