Active NPI
Thea A Richardson, PA-C
- Medical Physician Assistant
- Clearfield, PA
National Provider Identifier
1275583247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- OS000518L
- Practice address
- 1036 Park Avenue Ext
Clearfield, PA 16830-4028 - Phone
- (814) 765-9677
- NPI assigned
- May 11, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | OS000518L | PA | Primary |
Addresses
Primary practice location
1036 Park Avenue Ext
Clearfield, PA 16830-4028
Mailing address
749 Maple St
Brockway, PA 15824-1405
Phone (814) 661-3733
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS000518L | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1275583247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 MAPLE ST",
"city": "BROCKWAY",
"state": "PA",
"postal_code": "158241405",
"telephone_number": "814-661-3733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 PARK AVENUE EXT",
"city": "CLEARFIELD",
"state": "PA",
"postal_code": "168304028",
"telephone_number": "814-765-9677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "THEA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "OS000518L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearfield, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.