Active NPI
Michel Rivlin, M.D.
- Gynecology Physician
- Jackson, MS
National Provider Identifier
1902833429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 8037
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 984-5373
- Fax
- (601) 984-5476
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 8037 | MS | Primary |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5373
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 512G700003 | Other | MS | UP MEDICARE GROUP PROV# |
| 512I160014 | Other | MS | MEDICARE PTAN |
| P00616899 | Other | MS | UP RR MEDICARE PTAN# |
| 00016020 | Medicaid | MS | |
| 08103071 | Other | MS | UP MEDICAID GROUP PROV# |
| 160039244 | Other | MS | RR MEDICARE NUMBER |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8037 | MS | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1902833429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5373",
"fax_number": "601-984-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5373",
"fax_number": "601-984-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVLIN",
"first_name": "MICHEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "MS",
"license": "8037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UP MEDICARE GROUP PROV#",
"identifier": "512G700003",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "512I160014",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UP RR MEDICARE PTAN#",
"identifier": "P00616899",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00016020",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UP MEDICAID GROUP PROV#",
"identifier": "08103071",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE NUMBER",
"identifier": "160039244",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.