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KENNETH RIVERA PHYSICIAN ASSISTANT
NPI 1780399501
Physician Assistant in Cannon Afb, NM

Active since January 16, 2023
104 W D. L. INGRAM AVE, CANNON AFB, NM 88101(575) 784-2778 Get Directions Write a Review

NPPES record last updated: March 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 8, 2024, Jan 16, 2023 (2 updates tracked since 2023).

About Kenneth Rivera Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH RIVERA PHYSICIAN ASSISTANT (NPI 1780399501) is an individual physician assistant in Cannon Afb, New Mexico and active in the NPI registry since January 2023.

NPPES Registry Identity

NPI1780399501
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKENNETH RIVERACredential: PHYSICIAN ASSISTANT
Location Address104 W D. L. INGRAM AVECannon Afb, NM 88101
Mailing Address104 W D. L. Ingram AveCannon Afb, NM 88101 · (575) 784-2778
Phone(575) 784-2778
Sole ProprietorNo
Enumeration DateJanuary 16, 2023
Last NPPES UpdateMarch 8, 20242 updates tracked since enumeration
NPPES CertifiedMarch 8, 2024
✔ NPI 1780399501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
104 W D. L. INGRAM AVE, Cannon Afb, NM 88101
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIK M WALDRIP IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
104 W D. L. INGRAM AVE
CANNON AFB, NM 88101
Curry County (277) 857-5784
BRANDI KONIECZYNSKI
Military Health Care Provider (Independent Duty Medical Technicians)
104 W D. L. INGRAM AVE
CANNON AFB, NM 88101
Curry County (575) 904-3802
JOSHUA MORALES
Social Worker (Clinical)
104 W D. L. INGRAM AVE
CANNON AFB, NM 88101
Curry County (575) 904-3901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Rivera's NPI number?

The NPI number for Kenneth Rivera is 1780399501. It was assigned to this individual provider in the NPPES registry on January 16, 2023.

Where is Kenneth Rivera located?

Kenneth Rivera practices at 104 W D. L. Ingram Ave, Cannon Afb, NM 88101. The listed phone number is (575) 784-2778.

What is Kenneth Rivera's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Rivera was last updated on March 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.