Mark Richardson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8131 Issued in AZ

Practice address

4212 N 16TH St
Phoenix, AZ 85016-5319

Phone

(602) 263-1200

NPI assigned

Sep 11, 2015

Last updated

Apr 11, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dhew Ind HLTH SV HLTH SVS and MNTL HLTH AdmGroup PAC ID 1759290901, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Indian Medical Center Hospital, Phoenix, AZ, CCN 030078

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Phoenix Indian Medical Center

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment Care Compare group NPD
• Alliance Urgent Care PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tolleson, AZ
  • NPI 1891888517
  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Yavapai-Apache Health Center

  • Public Health or Welfare Agency
  • Camp Verde, AZ
  • NPI 1205859618
  NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Ak-Chin Clinic

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD
• Arizona Heart Specialists PLLC

  • Cardiovascular Disease Physician
  • Lakeside, AZ
  • NPI 1750513438
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1215305933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MARK",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri Lynn Richardson, PA-C
• Kitty Lee Richardson
• Landon C Richardson, DNP
• Leesha Nicole Richardson, AGNP-C
• Logan Richardson, OTR/L
• Marnie Richardson
• Nicole Richardson, LAC
• Patrick Richardson, APRN
• Paula C Richardson, PA-C
• Randy Richardson, MD

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.