Gladys Maria Rivero, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001010135 Issued in NC

Practice address

3450 Sandystone Cir
Fayetteville, NC 28311-2503

Phone

(910) 728-1787

NPI assigned

Aug 24, 2009

Last updated

Aug 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1891928941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 SANDYSTONE CIR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112503",
            "telephone_number": "910-728-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 SANDYSTONE CIR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112503",
            "telephone_number": "910-728-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "GLADYS",
        "middle_name": "MARIA",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001010135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellianne Rivera
• Maria Rivera, LCSW
• Mona Lisa Rivera, MA
• Nilvia Rivera
• Samantha Rivera
• Rivers of Peace Counseling Services, PLLC
• Kathleen Rivers, NP
• Kenneth Rivers
• Rueben N Rivers, MD
• Michael Robert Rizzone, DDS

• Medical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.