NPIMap

Organization Active NPI

Rivera Optometric Group P.C.

  • Optometrist
  • West Plains, MO
National Provider Identifier
1831455179
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2011037045 Issued in MO
Legal business name
RIVERA OPTOMETRIC GROUP P.C.
Practice address
1310 Preacher Roe Blvd # HGW
West Plains, MO 65775-2938
Phone
(417) 257-2807
Fax
(417) 257-2815
NPI assigned
Apr 10, 2012
Last updated
Apr 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Angel Keith Rivera, O.D.NPI 1982972063
Title
President
Phone
(417) 204-2320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2011037045 MO Primary

Addresses

Primary practice location

1310 Preacher Roe Blvd # HGW
West Plains, MO 65775-2938

Mailing address

PO Box 1701
West Plains, MO 65775-7001
Phone (417) 204-2320

National Provider Directory

National Provider Directory

Locations

1310 Preacher Roe Blvd
West Plains, MO 65775
Phone (417) 256-7114

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1831455179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1701",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657757001",
            "telephone_number": "417-204-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PREACHER ROE BLVD # HGW",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752938",
            "telephone_number": "417-257-2807",
            "fax_number": "417-257-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERA OPTOMETRIC GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-204-2320",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011037045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.