Individual provider Active NPI

Rebecca Faith Richardson

  • Physician Assistant
  • Clemmons, NC
National Provider Identifier
1184070237
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06391 Issued in NC
Practice address
4136 Clemmons Rd
Clemmons, NC 27012
Phone
(336) 893-3270
NPI assigned
May 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06391 NC Primary

Addresses

Primary practice location

4136 Clemmons Rd
Clemmons, NC 27012

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

1122 Randolph St Ste 110
Thomasville, NC 27360-5730
Phone (336) 481-0739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160725001629 NC Practitioner - Physician Assistant 6406149715 Reassigns benefits to 3 organizations
I20240508002292 WV Practitioner - Physician Assistant 6406149715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

1123 N Church St
Greensboro, NC 27401-1007
Phone (336) 832-4400

1127 N Church St
Greensboro, NC 27401-1007
Phone (336) 832-7100

1977 Cotton Grove Rd
Lexington, NC 27292-5721
Phone (336) 443-6041

3711 Elmsley St
Suite 102
Greensboro, NC 27406-7039
Phone (336) 890-2200

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

5303 Poplar Tent Rd
Suite 90
Concord, NC 28027-9720
Phone (980) 866-4493

600 Highland Oaks Dr
Winston Salem, NC 27103-7107
Phone (366) 774-0040

910 E Innes St
Salisbury, NC 28144-4638
Phone (844) 266-8268

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06391NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc CurrentSince Aug 29, 2022 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Jan 6, 2025 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Sep 6, 2025 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

4136 Clemmons Rd
Clemmons, NC 27012
Phone (336) 893-1300

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

300 E Wendover Ave
Fl 2
Greensboro, NC 27401
Phone (336) 663-5219

1122 Randolph St
Ste 110
Thomasville, NC 27360
Phone (336) 474-3433

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1184070237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "27012",
            "telephone_number": "336-893-3270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 Randolph St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "NC",
            "postal_code": "273605730",
            "country_code": "US",
            "telephone_number": "336-481-0739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "REBECCA",
        "middle_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.