NPI Code Detail JSON Logo

1942595228 NPI number — SHAYNA COLLEEN RIVARD MD

NPI Number: 1942595228
Health Care Provider/Practitioner: SHAYNA COLLEEN RIVARD MD

Information about “1942595228” NPI (SHAYNA COLLEEN RIVARD MD) exists in 1942595228 in HTML format HTML  |  1942595228 in plain Text format TXT  |  1942595228 in PDF (Portable Document Format) PDF  |  1942595228 in an XML format XML  formats.

NPI Number : 1942595228 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1942595228",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RIVARD",
    "FirstName": "SHAYNA",
    "MiddleName": "COLLEEN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "ADULT & PEDIATRIC DERMATOLOGY, PC",
    "SecondLineMailingAddress": "55 MILL STREET",
    "MailingAddressCityName": "WOLFEBORO",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03894",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-626-7546",
    "MailingAddressFaxNumber": "603-569-5046",
    "FirstLinePracticeLocationAddress": "55 MILL ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WOLFEBORO",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03894-4328",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-569-3376",
    "PracticeLocationAddressFaxNumber": "603-569-5046",
    "EnumerationDate": "06/14/2011",
    "LastUpdateDate": "07/17/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "02/25/2020",
    "NPIReactivationDate": "03/20/2020",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "22256",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "0101252746",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "T6024",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "MD0000064760",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "ME144349",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ND0101X",
          "TaxonomyName": "MOHS-Micrographic Surgery Physician",
          "LicenseNumber": "22256",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.