Individual provider Active NPI

Latonia Richardson

  • Occupational Therapist
  • Matthews, NC
National Provider Identifier
1255875332
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16661 Issued in NC
Practice address
600 Fullwood Rd
Matthews, NC 28105-2659
Phone
(704) 841-4920
NPI assigned
Dec 8, 2016
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 16661 NC Primary

Addresses

Primary practice location

600 Fullwood Rd
Matthews, NC 28105-2659

Mailing address

11 Diamond CT
Durham, NC 27703-6662
Phone (910) 431-3380

Other practice location 1

113 S Railroad Ave
Dunn, NC 28334-4853
Phone (910) 891-1599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021002535 NC Practitioner - Occupational Therapist in Private Practice 1153853718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16661NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Jul 29, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 29, 2024 Accepting new patients
Trinity Rehab LLC PastSince Sep 25, 2022 Accepting new patients

Locations

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1255875332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DIAMOND CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277036662",
            "telephone_number": "910-431-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FULLWOOD RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052659",
            "telephone_number": "704-841-4920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 S Railroad Ave",
            "address_purpose": "LOCATION",
            "city": "Dunn",
            "state": "NC",
            "postal_code": "283344853",
            "country_code": "US",
            "telephone_number": "910-891-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LATONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.