Fred Richardson Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036078174 Issued in IL

Practice address

904 Medical Park Dr
Suite 3
Effingham, IL 62401-2193

Phone

(217) 540-2350

Fax

(217) 347-2323

NPI assigned

Dec 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Rush Medical College of Rush University, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Icare Home Health Home health agency, Chicago, IL, CCN 148039
• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Little Company of Mary Affiliated Services Inc

  • Urgent Care Clinic/Center
  • Oak Lawn, IL
  • NPI 1033162086
  Medicare reassignment NPD
• Little Company of Mary Affiliated Services Inc

  • Internal Medicine Physician
  • Evergreen Park, IL
  • NPI 1588617260
  NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

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

• Icare Home Health Corporation

  • Home Health Agency
  • Chicago, IL
  • NPI 1992912182
  Care Compare affiliation
• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1194702092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 MEDICAL PARK DR",
            "address_2": "SUITE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012193",
            "telephone_number": "217-540-2350",
            "fax_number": "217-347-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 MEDICAL PARK DR",
            "address_2": "SUITE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012193",
            "telephone_number": "217-540-2350",
            "fax_number": "217-347-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 W Court St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013695",
            "country_code": "US",
            "telephone_number": "815-937-8744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "FRED",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036078174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078174",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frichardson134844@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "455 W Court St Ste 400",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609013695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghan A Rewers
• Rhodes to Health, LLC
• Rhodes to Health, LLC
• Paul G Rhodes, D.C.
• Lindell Lee Richards, P.T.
• Maci Rieman, PHARMD
• Kalei Marie Rincker
• Kathryn Michelle Rincker, APRN
• Iris M Rivera
• Haylie Grace Roark, MHP

• Family Medicine Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.