Jennifer Lynn Rivenburgh, NP-P

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F402794 Issued in NY

Practice address

11-21 Broadway St
Gloversville, NY 12078-3964

Phone

(518) 725-4310

Fax

(518) 725-2988

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of Ny Upstate Medical University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Family Counseling Center of Fulton County IncGroup PAC ID 0042283335, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Family Counseling Center of Fulton County Inc

  • Mental Health Counselor
  • Gloversville, NY
  • NPI 1164473831

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1952962185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11-21 BROADWAY ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783964",
            "telephone_number": "518-725-4310",
            "fax_number": "518-725-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11-21 BROADWAY ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783964",
            "telephone_number": "518-725-4310",
            "fax_number": "518-725-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVENBURGH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "720511",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jordana Rhodes, LMSW
• Judy Lynn Rhodes, RN
• Gillian Farrell Rice, PMHNP
• Shelbi Rae Rippel, PMHNP-BC
• Rite Aid of New York Inc (Rite Aid Pharmacy 00590)
• Victor Antonio Rivera Colon
• Lisa Robare
• Christine Robataille, RPH
• Joanne Louise Robbins, RN
• Robert C Warner, Jr., MD

• Psychiatric/Mental Health Nurse Practitioner in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.