Vanessa Renee Richardson, MS, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31007103A Issued in IN

Practice address

21 S Park Blvd Ste 21
Greenwood, IN 46143-8838

Phone

(317) 449-2104

Fax

(317) 520-8200

NPI assigned

Apr 8, 2020

Last updated

Nov 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1295364479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 HAWTHORNE LN",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429430",
            "telephone_number": "317-332-9861",
            "fax_number": "317-893-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S PARK BLVD STE 21",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438838",
            "telephone_number": "317-449-2104",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "VANESSA",
        "middle_name": "RENEE",
        "credential": "MS, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007103A",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "433646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard S Gillum Inc PC
• Ja-Lisa Richard, RBT
• Jon Anthony Richardson
• Michael Wilson Richardson, CMT
• Raychel Richardson, RBT
• Charles L Richert, M.D.
• Amy Richwine, NP
• Hannah Rickett
• Kasie Ridge
• Leslie Rielage-Ralph, LCPC, LMHC

• Occupational Therapist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.