Individual provider Active NPI

Benjamin Russell Richardson, D.O.

  • Obstetrics & Gynecology Physician
  • Show Low, AZ
National Provider Identifier
1215222013
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
006656 Issued in AZ
Practice address
4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone
(928) 537-6700
Fax
(928) 532-2198
NPI assigned
Jun 9, 2011
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 006656 AZ Primary

Addresses

Primary practice location

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827

Mailing address

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone (928) 537-6700

Other identifiers 1

IdentifierTypeStateIssuer
022296MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20151218001730 AZ Practitioner - Obstetrics/Gynecology 0941510598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1121 S Main St
Snowflake, AZ 85937-5645
Phone (928) 536-5858

4951 S White Mountain Rd
BLDG a
Show Low, AZ 85901-7801
Phone (928) 537-6700

625 N 13TH
St Johns, AZ 85936-1019
Phone (928) 337-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
006656AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates CurrentSince Sep 26, 2015 Accepting new patients
Summit Healthcare Association Current Accepting new patients
Summit Healthcare Medical Associates Family Medicine CurrentSince Sep 26, 2015 Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700

5171 S Cub Lake Rd
Ste B210
Show Low, AZ 85901
Phone (928) 532-8386

1121 S Main St
Snowflake, AZ 85937
Phone (928) 532-3008

590 S Main St
Snowflake, AZ 85937
Phone (520) 536-7519

Interoperability endpoints

  • Direct secure messaging: benjaminrichardson@shrmcshma.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1215222013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BENJAMIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "006656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022296",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.