Nicole Rivera

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

720 Ralph McGill Blvd NE Unit 509
Atlanta, GA 30312-1197

Phone

(802) 595-1933

NPI assigned

Sep 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1821877259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 RALPH MCGILL BLVD NE UNIT 509",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121197",
            "telephone_number": "802-595-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 RALPH MCGILL BLVD NE UNIT 509",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121197",
            "telephone_number": "802-595-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daylene Rivera
• Jerry Rivera
• Mario Rivera, M.D
• Michael A Rivera, MS
• Natalie Isabella Rivera, PA STUDENT
• Samantha Rivera
• Sylvia Elizabeth Rivera, LCSW
• Riverbend OB-GYN & Counseling
• Georgia Pilar Rivero
• Candice Ann Rivers

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.