Individual provider Active NPI

Michael D Richardson, MD

  • Internal Medicine Physician
  • Dickson, TN
National Provider Identifier
1184603839
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21630 Issued in TN
Practice address
1904 Highway 46 S Ste 3
Dickson, TN 37055-7745
Phone
(615) 441-6000
NPI assigned
Jan 11, 2006
Last updated
Jan 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21630 TN Primary

Addresses

Primary practice location

1904 Highway 46 S Ste 3
Dickson, TN 37055-7745

Mailing address

PO Box 3370
Clarksville, TN 37043-3370
Phone (931) 647-5034

Other practice location 1

1226 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Emergency Physicians PLLC Specialist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1184603839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3370",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433370",
            "telephone_number": "931-647-5034",
            "fax_number": "931-552-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 HIGHWAY 46 S STE 3",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370557745",
            "telephone_number": "615-441-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1226 Trotwood Ave",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384014802",
            "country_code": "US",
            "telephone_number": "931-381-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "21630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.