Kenneth J Richter, DO

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

5101007564 Issued in MI

Practice address

34505 West 12 Mile Rd Suite 100
Farmington Hills, MI 48331

Phone

(734) 343-7500

Fax

(312) 957-9991

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Oakland Physiatry P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Pontiac, MI
  • NPI 1457498081
  Medicare reassignment NPD
• SJMH Medical Practice-SMHC

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1346284684
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1033159132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34505 WEST 12 MILE RD SUITE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48331",
            "telephone_number": "734-343-7500",
            "fax_number": "312-957-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34505 WEST 12 MILE RD SUITE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48331",
            "telephone_number": "734-343-7500",
            "fax_number": "312-957-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": false
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101007564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905041 TYPE 11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Richmond
• Jeannette Isabella Richmond
• Kari Richmond, LLC
• Alyson Richter
• Danielle Richter
• Novlene Rickaby
• Brianna Rickel, PA-C
• Chloe Rickerman
• Sharon Rickers
• Ashleigh Rickert

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.

Verify at the official NPI Registry.