MEDICARE: SAMANTHA D RIVERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		DC
2	3747P1801X	Personal Care Attendant		DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497366959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA D RIVERS

Provider Business Mailing Address
First Line	:	2401 CALVERT ST NW APT 615
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2671
Country	:	US
Telephone Number	:	240-370-7071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 GOOD HOPE RD SE APT 421
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5118
Country	:	US
Telephone Number	:	202-640-8497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	04/06/2026

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Directions to “ SAMANTHA D RIVERS ” Practice Location

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