Rivers Edge Primary Care LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

RIVERS EDGE PRIMARY CARE LLC

Practice address

821 E Main St Ste 3
Chicopee, MA 01020-6306

Phone

(413) 695-6774

NPI assigned

Feb 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer L Jordan, DNP

Title

Member

Phone

(413) 695-6774

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1790378487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E MAIN ST STE 3",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010206306",
            "telephone_number": "413-695-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E MAIN ST STE 3",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010206306",
            "telephone_number": "413-695-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERS EDGE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "413-695-6774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desire Rivera, MA COUNSELING
• Manuel Rivera Jr.
• Riverbend Medical Group, Inc
• Riverbend Medical Group, Inc
• Riverbend Oral and Maxillofacial Surgery, PLLC
• Jill Marie Roach, P.T.
• Robert G. Rafferty, DMD, PC
• Linda Robins
• Colin James Robinson, PA
• Susan Rochon, P.T.

• Primary Care Nurse Practitioner in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Primary Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.