George M Rivera Jr., PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160008211 Issued in IL

Practice address

505 College Ave
Ottawa, IL 61350-3858

Phone

(815) 434-1130

NPI assigned

Feb 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1871050849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 COVEY LN",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604162442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 COLLEGE AVE",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503858",
            "telephone_number": "815-434-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "GEORGE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160008211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rezin Orthopedics and Sports Medicine, SC
• Richard a Ewald and William L Wrobel DDS LTD
• Julia Rae Richards, M.S.,CCC-SLP/L
• Natasha Rinaldi, LCSW
• Kaitlyn Rinke, LCPC
• Emily Nicole Roach
• Robert W. Schmidt, D.D.S., F.a.G.D., P.C.
• Mildred Elizabeth Roberts, LCSW
• Cambria Robinson
• Cynthia Joann Robinson, LCSW

• Physical Therapy Assistant in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.