Individual provider Active NPI

James Randall Richard, MD

  • Family Medicine Physician
  • Fremont, OH
National Provider Identifier
1023110335
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35044926 Issued in OH
Practice address
2221 Hayes Ave
Fremont, OH 43420-2632
Phone
(419) 334-8943
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35044926 OH Primary

Addresses

Primary practice location

2221 Hayes Ave
Fremont, OH 43420-2632

Mailing address

2221 Hayes Ave # 2
Fremont, OH 43420-2632
Phone (419) 334-8943

Other identifiers 1

IdentifierTypeStateIssuer
0709657MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000363 OH Practitioner - Family Practice 8123209608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35044926OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community and Rural Health Services CurrentSince Aug 20, 2012 Accepting new patients
Community and Rural Health Services Past Accepting new patients

Locations

2221 Hayes Ave
Fremont, OH 43420
Phone (419) 334-3869

2221 Hayes Ave
#2
Fremont, OH 43420

410 Birchard Ave
Fremont, OH 43420
Phone (419) 334-3869

3909 Kok Rd
Willard, OH 44890
Phone (419) 933-7408

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIFECD/Endpoint/CIFECD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1023110335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 HAYES AVE # 2",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202632",
            "telephone_number": "419-334-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202632",
            "telephone_number": "419-334-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "JAMES",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35044926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0709657",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.