Individual provider Active NPI

Mary C Rivers, NP

  • Otorhinolaryngology & Head-Neck Registered Nurse
  • Rochester, NY
National Provider Identifier
1902832165
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otorhinolaryngology & Head-Neck Registered NurseTaxonomy code 163WX0601X
License
F330916 Issued in NY
Practice address
2365 Clinton Ave S
Suite 200
Rochester, NY 14618-2645
Phone
(585) 758-5700
Fax
(585) 758-1293
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otorhinolaryngology & Head-Neck Registered Nurse 163WX0601X F330916 NY Primary

Addresses

Primary practice location

2365 Clinton Ave S
Suite 200
Rochester, NY 14618-2645

Mailing address

601 Elmwood Ave
Box 629
Rochester, NY 14642-0001
Phone (585) 758-5700

Other identifiers 3

IdentifierTypeStateIssuer
P019330916OtherNYBLUE CHOICE
02430495MedicaidNY
CW109237OtherNYPREFERRED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F330916NYMDOtorhinolaryngology & Head-Neck Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1902832165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 629",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-758-5700",
            "fax_number": "585-758-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 CLINTON AVE S",
            "address_2": "SUITE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182645",
            "telephone_number": "585-758-5700",
            "fax_number": "585-758-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0601X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Otorhinolaryngology & Head-Neck",
            "state": "NY",
            "license": "F330916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019330916",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02430495",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "CW109237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.