Crystal Lee Richerson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1140 Issued in OK

Practice address

13301 N Meridian Ave
BLDG. 400
Oklahoma City, OK 73120-9369

Phone

(405) 755-4600

Fax

(405) 755-4837

NPI assigned

Dec 11, 2009

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• G. Michael Steelman, M.D., Inc.

  • Specialist
  • Oklahoma City, OK
  • NPI 1063502441
  NPD (past)
• SCWW LLC

  • Pharmacy
  • Oklahoma City, OK
  • NPI 1770128084
  NPD (past)

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1184953689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13301 N MERIDIAN AVE",
            "address_2": "BLDG. 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209369",
            "telephone_number": "405-755-4600",
            "fax_number": "405-755-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 N MERIDIAN AVE",
            "address_2": "BLDG. 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209369",
            "telephone_number": "405-755-4600",
            "fax_number": "405-755-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "CRYSTAL",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-11",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA1140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Jace Richardson, PA
• Tisha Denise Richardson, LPN
• Trudy T. Richardson, P. T.
• Willard Keith Richardson
• Kacy Anne Richburg, MD
• Emily Serena Richert, APRN
• Nicholas Richert, LMSW
• Dwight Richey, MS, LPC
• Tandi Richey
• Keosha Richie

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.