Active NPI
David Bruce Richardson, M.D.
- Family Medicine Physician
- Keene, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12715
- Practice address
- 69 Island St Ste C
Keene, NH 03431-3507 - Phone
- (603) 654-6700
- Fax
- (603) 354-6704
- NPI assigned
- Jul 14, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A061532 | CA | |
| Family Medicine Physician | 207Q00000X | 12715 | NH | Primary |
Addresses
Primary practice location
69 Island St Ste C
Keene, NH 03431-3507
Mailing address
69 Island St Ste C
Keene, NH 03431-3507
Phone (603) 654-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30205478 | Medicaid | NH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050726001200 | CA | Practitioner - Family Practice | 9032146527 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Washington University School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
12100 Euclid St
Garden Grove, CA 92840-3304
Phone (888) 988-2800
23781 Maquina
Mission Viejo, CA 92691-2716
Phone (888) 988-2800
3401 S Harbor Blvd
Santa Ana, CA 92704-7933
Phone (888) 988-2800
5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61532 | CA | MD | General Practice Dentistry |
| A061532 | CA | MD | Family Medicine Physician |
| 12715 | NH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Past | Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Past | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
393 E Walnut St
Unit 3
Pasadena, CA 91188
Organizations & group practices 8
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
CA
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Clinical Medical Laboratory
- N Hollywood, CA
- NPI 1891873303
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Anaheim, CA
- NPI 1952333460
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
-
- Community/Retail Pharmacy
- Keene, NH
- NPI 1033761739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1083630784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 ISLAND ST STE C",
"city": "KEENE",
"state": "NH",
"postal_code": "034313507",
"telephone_number": "603-654-6700",
"fax_number": "603-354-6704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 ISLAND ST STE C",
"city": "KEENE",
"state": "NH",
"postal_code": "034313507",
"telephone_number": "603-654-6700",
"fax_number": "603-354-6704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "DAVID",
"middle_name": "BRUCE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A061532",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "12715",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30205478",
"state": "NH"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "441 N Lakeview Ave",
"city": "Anaheim",
"state": "CA",
"country_code": "US",
"postal_code": "928073028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Keene, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.