Kristy J Richardson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71003001A Issued in IN

Practice address

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Phone

(260) 436-8686

Fax

(260) 436-8585

NPI assigned

Aug 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Fort Wayne Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1497758429

  Family

  Medicare reassignment NPD
• Fort Wayne Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Gas City, IN
  • NPI 1699425082
  NPD
• Emergency Medicine of Indiana

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1952356883
  NPD (past)
• Emergency Medicine of Indiana LLC

  • Emergency Medicine Physician
  • Fort Wayne, IN
  • NPI 1881969418
  NPD (past)
• Emergency Physicians of Indiana PC

  • Emergency Medicine Physician
  • Auburn, IN
  • NPI 1003869454
  NPD (past)

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1093946006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468012526",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044133",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KRISTY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003001A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01478538",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200957030",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000816667",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Richardson
• Brenda Priscilla Richardson, RN
• Casey R. Richardson, NP
• Jamie Lynne Richardson, FNP
• Janette Richardson, MSN, RN, AGCNS-BC
• Marcy Richardson
• Mary Richardson, MA CCC-SLP
• Rita M. Richardson, MD
• Eva Marie Richardville, OTR
• Heather Marie Richardville, DPT

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.