Active NPI
Peter Richardson, DO
- Family Medicine Physician
- Carthage, MO
National Provider Identifier
1144251646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R8689
- Practice address
- 719 W Centennial
Carthage, MO 64836 - Phone
- (417) 358-1002
- Fax
- (417) 358-8660
- NPI assigned
- Jul 5, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R8689 | MO | Primary |
Addresses
Primary practice location
719 W Centennial
Carthage, MO 64836
Mailing address
PO Box 3810
Joplin, MO 64803
Phone (417) 358-1002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8980 | Other | MO | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8689 | MO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1144251646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3810",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64803",
"telephone_number": "417-358-1002",
"fax_number": "417-358-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 W CENTENNIAL",
"city": "CARTHAGE",
"state": "MO",
"postal_code": "64836",
"telephone_number": "417-358-1002",
"fax_number": "417-358-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "PETER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R8689",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "8980",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carthage, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.