Tommy Rivera

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Practice address

6387 Camp Bowie Blvd Ste B512
Fort Worth, TX 76116-5423

Phone

(817) 939-7434

NPI assigned

May 22, 2023

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Prime Landing LLC

  dba Prime Landing

  • Contractor
  • Fort Worth, TX
  • NPI 1821876285
  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1932891538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6387 CAMP BOWIE BLVD STE B512",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165423",
            "telephone_number": "817-939-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 CAMP BOWIE BLVD STE B512",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165423",
            "telephone_number": "817-939-7434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4712 Rockmoor Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761168729",
            "country_code": "US",
            "telephone_number": "817-939-7434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "TOMMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Rivera
• Jasmine Ruby Rivera
• Jonathan Louis Rivera
• Kellye Rivera
• Kelsey Lynn Rivera, PHARM.D
• Chalee L Rivers, RN
• David Bryan Rivers, BEHAVIOR ANALYST
• Nicole Rivers, NRCMA
• Pamela K Rivers, RN
• Rivsal Corporation, Inc.

• Point of Service in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.