Individual provider · Type 1 NPI

Kelly Larose Rivera, PA-C

Physician Assistant · Columbia, SC

NPI number 1689263352 Active

Practice location

3 Richland Medical Park Dr Ste 100
Columbia, SC 29203-6850

Call (803) 736-3277 Map

Mailing address

15 Exchange Dr
Lugoff, SC 29078-9198

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X4543 (SC)

Physician Assistant: 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, orde…

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About NPI 1689263352

Kelly Larose Rivera, PA-C's National Provider Identifier is 1689263352, issued on Jan 15, 2021. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Columbia, SC. The record was last updated on Mar 27, 2026.