Active NPI
James Randall Richard, MD
- Family Medicine Physician
- Fremont, OH
National Provider Identifier
1023110335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35044926
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0709657 | Medicaid | OH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35044926 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community and Rural Health Services | Current | 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
- 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.
-
- Rural Health Clinic/Center
- Fremont, OH
- NPI 1780683573
-
- Rural Health Clinic/Center
- Fremont, OH
- NPI 1437321239
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.