Individual provider Active NPI

Jessica Rivera, PT

  • Physical Therapist
  • Salisbury, NC
National Provider Identifier
1891937504
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12072 Issued in NC
Practice address
810 Mitchell Ave
Salisbury, NC 28144-6253
Phone
(704) 216-5633
Fax
(704) 639-0785
NPI assigned
Mar 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1352 NC
Physical Therapist 225100000X 12072 NC Primary

Addresses

Primary practice location

810 Mitchell Ave
Salisbury, NC 28144-6253

Mailing address

PO Box 602362
Charlotte, NC 28260-2362
Phone (704) 603-1403

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JRIVERA36476@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090416000029 NC Practitioner - Physical Therapist in Private Practice 5991852600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12072NCMDPhysical Therapist
1352NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group Inc CurrentSince Jan 1, 2013 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2013 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1910 Jake Alexander Blvd W
Ste 202
Salisbury, NC 28147
Phone (704) 216-5633

810 Mitchell Ave
Salisbury, NC 28144
Phone (704) 216-2633

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1410 Fern Creek Dr
Statesville, NC 28625
Phone (704) 873-6863

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jrivera36476@direct.novanthealth.org

Organizations & group practices 4

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": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1891937504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602362",
            "telephone_number": "704-603-1403",
            "fax_number": "704-603-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MITCHELL AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446253",
            "telephone_number": "704-216-5633",
            "fax_number": "704-639-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-26",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1352",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "12072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JRIVERA36476@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "810 Mitchell Ave",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281446253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.