Ebony Makeda Richards, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101258488 Issued in VA

Practice address

14139 Potomac Mills Road
Pediatrics
Woodbridge, VA 22192

Phone

(703) 359-7878

Fax

(703) 490-7695

NPI assigned

Apr 19, 2012

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Loudoun Medical Center

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Tysons Corner Medical Center

  • Health Maintenance Organization
  • McLean, VA
  • NPI 1376815472
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1235496811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14139 POTOMAC MILLS ROAD",
            "address_2": "PEDIATRICS",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-359-7878",
            "fax_number": "703-490-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14139 POTOMAC MILLS ROAD",
            "address_2": "PEDIATRICS",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-359-7878",
            "fax_number": "703-490-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "EBONY",
        "middle_name": "MAKEDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101258488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14139 Potomac Mills Road",
            "address_2": "Pediatrics",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "22192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Ri'Chard, DNP, FNP-BC
• Walton Rice, OD
• Richard G Tami DDS PC
• Richard G. Robinson, M.D & Mark J. Clinton, M.D., P.C.
• Richard J Hwang MD PC
• Christina Michelle Richardson
• Stephanie Lee Richardson, MOT, OTR/L
• Ridgeview Internal Medicine
• James Justin Ridley, PHARMD
• Lorraine Dolores Riggers-Lassman, O.D.

• Pediatrics Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.