DR. EDGARDO DAVID RIVERA-RIVERA (NPI# 1710151303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710151303 |
| Entity Type | Individual |
| Full Name | DR. EDGARDO DAVID RIVERA-RIVERA |
| Credential | M.D. |
| Practice Address |
11123 Parkview Plaza Dr Ste 201 Fort Wayne IN 46845-1707 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2604255950 |
| Practice Fax Number | 2604255165 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
01081050A | IN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1611 Nw 12th Ave, Miami, FL 331361005 | 3052433166 |
| Street Address |
11123 PARKVIEW PLAZA DR STE 201 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326139833 | Audrey Fawn Sofair | Physical Medicine & Rehabilitation | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2006-09-28 |
| 1659928356 | Rylie Nicole Ousley | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2019-08-19 |
| 1598998247 | David R Baker | Physician Assistant | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2009-08-28 |
| 1265648299 | Diana Castanon Westgate | Dermatology | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2007-05-15 |
| 1972647444 | Robyn Denise Schmucker | Pediatrics | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2007-02-17 |
| 1053471250 | Anthony M Savo | Transplant Surgery | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699871434 | Steven W. Fitts | Pediatrics | 7910 W Jefferson Blvd Ste 205b, Fort Wayne, IN 46804-4159 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902022049 | Arthur Ray Euler | Pediatrics | 2316 Stacey Hollow Pl, Lafayette, IN 47905-8506 | 2007-04-17 |
| 1386689354 | Rebecca G Carey | Pediatrics | 3900 Washington Ave Ste 100, Evansville, IN 47714 | 2006-06-16 |
| 1851950224 | St Vincent Pediatric Subspecialties | Pediatrics | 3700 Washington Ave, Evansville, IN 47714-0541 | 2019-06-10 |
| 1457797060 | Brandon Arnold Sparks | Pediatrics | 705 Riley Hospital Dri, Indianapolis, IN 46202-5109 | 2013-05-22 |
| 1316205495 | St. Vincent Hospital and Health Care Center, Inc. | Pediatrics | 8402 Harcourt Rd, Suite 402, Indianapolis, IN 46260-2074 | 2012-04-26 |
| 1669738241 | Sara Kristen Naramore | Pediatrics | 705 Riley Hospital Dr, Roc 4210, Indianapolis, IN 46202 | 2012-04-08 |
| 1487934204 | Kanika Puri | Pediatrics | 705 Riley Hospital Dr, Roc 4210, Indianapolis, IN 46202-5109 | 2011-08-24 |
| 1568618841 | Deaconess Clinic Inc | Pediatrics | 4133 Gateway Blvd, 2nd Floor, Newburgh, IN 47630-7918 | 2008-08-18 |
| 1679749360 | Emily C Hon | Pediatrics | 705 Riley Hospital Dr, Roc 4210, Indianapolis, IN 46202-5109 | 2008-05-02 |
| 1851566210 | William E. Bennett Jr. | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2008-04-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.