Active NPI
Angel Keith Rivera, OD
- Optometrist
- West Plains, MO
National Provider Identifier
1982972063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2011037045
- Practice address
- 1310 Preacher Roe Blvd # HGW
West Plains, MO 65775-2938 - Phone
- (787) 510-5403
- NPI assigned
- Dec 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2011037045 | MO | Primary |
Addresses
Primary practice location
1310 Preacher Roe Blvd # HGW
West Plains, MO 65775-2938
Mailing address
PO Box 1701
West Plains, MO 65775-7001
Phone (787) 510-5403
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1982972063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1701",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657757001",
"telephone_number": "787-510-5403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 PREACHER ROE BLVD # HGW",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752938",
"telephone_number": "787-510-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "ANGEL",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2011037045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.