Kelsey Eaves Rivenburgh
Physician Assistant in Oak Island, NC. Individual provider (NPI-1).
NPI number1497513873
StatusActive
Last updated in NPPESDec 20, 2024
Details
- NPI
- 1497513873
- Entity type
- Individual (NPI-1)
- Name
- Kelsey Eaves Rivenburgh
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 11, 2024
- Certification date
- Dec 20, 2024
- Last updated
- Dec 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
117 Ne 51st StOak Island, NC 28465-5118
Phone 910-777-4207
Mailing address
117 Ne 51st StOak Island, NC 28465-5118
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Other Physician Assistant providers in Oak Island, NC
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