Jessa Elizabeth Miles Richards

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114035 Issued in FL

Practice address

880 NW 13TH St Ste 2B
Boca Raton, FL 33486-2342

Phone

(561) 361-4075

NPI assigned

Apr 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1033671532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST STE 2B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-361-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST STE 2B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-361-4075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10437 S Jordan Gtwy",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840953915",
            "country_code": "US",
            "telephone_number": "480-720-9464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "JESSA",
        "middle_name": "ELIZABETH MILES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114035",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1175088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Nettboy DPM & Martin H Shank DPM PA
• Richard R Golden MD PA
• Richard Rosen Chiropractic PA
• Richard S Faulk MD PA
• Richard S Klein DC PA
• Kenneth Richards, PA
• Marc Spencer Richards, MD
• Eric Richardson, PT
• Ginette Riche, RPH
• Ashley Elizabeth Richie, AU.D.

• Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.