Individual provider Active NPI

Alexis Jean Rivera, APRN

  • Pediatric Nurse Practitioner
  • El Dorado, AR
National Provider Identifier
1801508775
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
220943 Issued in AR
Practice address
600 S Timberlane Dr
El Dorado, AR 71730-6990
Phone
(870) 862-2400
Fax
(870) 864-8142
NPI assigned
Dec 22, 2022
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 220943 AR Primary

Addresses

Primary practice location

600 S Timberlane Dr
El Dorado, AR 71730-6990

Mailing address

600 S Timberlane Dr
El Dorado, AR 71730-6990
Phone (870) 862-2400

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
220943ARMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robin Ray Pediatrics CurrentSince Jan 8, 2023 Accepting new patients
Sama Healthcare Services, PA Past Accepting new patients

Locations

403 W Oak St
Ste 301
El Dorado, AR 71730
Phone (870) 862-8221

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1801508775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S TIMBERLANE DR",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717306990",
            "telephone_number": "870-862-2400",
            "fax_number": "870-864-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S TIMBERLANE DR",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717306990",
            "telephone_number": "870-862-2400",
            "fax_number": "870-864-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "ALEXIS",
        "middle_name": "JEAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "220943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

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