Michael Blake Richardson, MD, DPT

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

E-19315 Issued in AR

Practice address

4206 Prince St
Conway, AR 72034-9398

Phone

(501) 499-8217

Fax

(501) 499-8227

NPI assigned

Sep 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Dermatology

Education

University of Arkansas College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Natural State Dermatology PLLC

  • Dermatology Physician
  • Conway, AR
  • NPI 1407719594
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Conway Regional Medical Center Inc

  • Rural Health Clinic/Center
  • Vilonia, AR
  • NPI 1063798858

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1497770424
  Care Compare affiliation
• Conway Regional Medical Center Inc

  • Clinical Medical Laboratory
  • Conway, AR
  • NPI 1609123017

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1245729359

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  • Psychiatry Physician
  • Conway, AR
  • NPI 1730402249

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Mayflower, AR
  • NPI 1851389605

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768694400000",
    "number": "1114474723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 PRINCE ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720349398",
            "telephone_number": "501-499-8217",
            "fax_number": "501-499-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 PRINCE ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720349398",
            "telephone_number": "501-499-8217",
            "fax_number": "501-499-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MICHAEL",
        "middle_name": "BLAKE",
        "credential": "MD, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E-19315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jinny Erin Richards, LPC
• Erin Elizabeth Richardson, SLP
• Kayla Richardson
• Lashanna Richardson, RECOVERY ASSISTANT
• Mary Richardson, RECOVERY ASSISTANT
• Tiffany Richardson
• Trent Richardson, RECOVERY ASSISTANT
• Nikki Danielle Rickman
• Keisha Ridgell, RECOVERY ASSISTANT
• Kelvin Ridgell Jr.

• Dermatology Physician in Conway, AR
• Providers in Conway, AR by specialty
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2026; 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.

Verify at the official NPI Registry.