Active NPI
Theresia Richardson
- Acute Care Nurse Practitioner
- Mesa, AZ
National Provider Identifier
1275142994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 250731
- Practice address
- 433 E 6TH St
Mesa, AZ 85203-7104 - Phone
- (480) 427-3000
- NPI assigned
- Jul 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 250731 | AZ | Primary |
Addresses
Primary practice location
433 E 6TH St
Mesa, AZ 85203-7104
Mailing address
2270 Weatherstone Cir SE
Conyers, GA 30094-2075
Phone (678) 620-6373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 250731 | AZ | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275142994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2270 WEATHERSTONE CIR SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300942075",
"telephone_number": "678-620-6373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 E 6TH ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852037104",
"telephone_number": "480-427-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "THERESIA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-28",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "250731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.