Bennett D Richardson, DPT

Key facts

NPI

1164935243

Entity type

Individual (NPI type 1)

Primary specialty

Orthopedic Physical Therapist 2251X0800X

License

PT026340 (PA)

Practice address

507 Pittsburgh St
Springdale, PA 15144-1409

Phone

(724) 275-7827

Fax

(724) 275-7749

NPI assigned

Nov 10, 2017

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 10, 2017.

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1164935243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 PITTSBURGH ST",
            "city": "SPRINGDALE",
            "state": "PA",
            "postal_code": "151441409",
            "telephone_number": "724-275-7827",
            "fax_number": "724-275-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 PITTSBURGH ST",
            "city": "SPRINGDALE",
            "state": "PA",
            "postal_code": "151441409",
            "telephone_number": "724-275-7827",
            "fax_number": "724-275-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BENNETT",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT026340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Springdale, PA · Orthopedic Physical Therapist in Pennsylvania