Individual provider Active NPI

Wilmalisse Natal Rivera, DC

  • Chiropractor
  • Trujillo Alto, PR
National Provider Identifier
1821849217
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
981 Issued in PR
Practice address
220 Western Auto Plaza
Ste 203
Trujillo Alto, PR 00976
Phone
(787) 292-0905
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 981 PR Primary

Addresses

Primary practice location

220 Western Auto Plaza
Ste 203
Trujillo Alto, PR 00976

Mailing address

PO Box 368
Salinas, PR 00751-0368
Phone (787) 632-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719002790 PR Practitioner - Chiropractic 0749726214 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
981PRMDRehabilitation Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Innerbloom Chiropractic Clinic LLC Chiropractor CurrentSince Apr 12, 2024 Accepting new patients

Locations

220 Plaza Western Auto
Ste 203
Trujillo Alto, PR 00976
Phone (787) 292-0905

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1821849217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "SALINAS",
            "state": "PR",
            "postal_code": "007510368",
            "telephone_number": "787-632-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 WESTERN AUTO PLAZA",
            "address_2": "STE 203",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-292-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATAL RIVERA",
        "first_name": "WILMALISSE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.