NPIMap

Individual provider Active NPI

John Middleton Lariviere, AGACNP-BC

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1982214136
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN.0995529-NP Issued in CO
Practice address
1914 Lelaray St
Colorado Springs, CO 80909-2800
Phone
(303) 746-3465
Fax
(719) 632-2925
NPI assigned
Aug 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0995529-NP CO Primary
Acute Care Nurse Practitioner 363LA2100X APN.0995529-NP CO

Addresses

Primary practice location

1914 Lelaray St
Colorado Springs, CO 80909-2800

Mailing address

1914 Lelaray St
Colorado Springs, CO 80909-2800
Phone (303) 746-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323002347 CO Practitioner - Nurse Practitioner 1658784459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pikes Peak Nephrology Associates PCGroup PAC ID 7719884931, 14 clinicians

Practice addresses (Care Compare)

1914 Lelaray St
Colorado Springs, CO 80909-2800
Phone (719) 632-7641

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0995529-NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pikes Peak Nephrology Associates PC Current Accepting new patients
Pikes Peak Nephrology Associates PC CurrentSince Apr 1, 2022 Accepting new patients
Pikes Peak Nephrology Associates PC CurrentSince Apr 1, 2022 Accepting new patients
Transtreme, LLC Family Past Accepting new patients

Locations

1914 Lelaray St
Colorado Springs, CO 80909
Phone (719) 955-2651

850 Eagleridge Blvd
Ste 100
Pueblo, CO 81008
Phone (866) 493-7217

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1982214136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 LELARAY ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092800",
            "telephone_number": "303-746-3465",
            "fax_number": "719-632-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 LELARAY ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092800",
            "telephone_number": "303-746-3465",
            "fax_number": "719-632-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIVIERE",
        "first_name": "JOHN",
        "middle_name": "MIDDLETON",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-03",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0995529-NP",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0995529-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.