Individual provider Active NPI

Geoffrey Dana Richardson, MD

  • Family Medicine Physician
  • Leavenworth, WA
National Provider Identifier
1316941727
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00036435 Issued in WA
Practice address
817 Commercial St
Leavenworth, WA 98826-1316
Phone
(509) 548-3420
Fax
(509) 548-2510
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00036435 WA Primary

Addresses

Primary practice location

817 Commercial St
Leavenworth, WA 98826-1316

Mailing address

817 Commercial St
Leavenworth, WA 98826-1316
Phone (509) 548-3420

Other identifiers 1

IdentifierTypeStateIssuer
8232449MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101018001149 WA Practitioner - Family Practice 2961695366 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chelan County Public Hospital District No. 1Group PAC ID 3971491234, shared by 3 NPIs, 23 clinicians

Practice addresses (Care Compare)

817 Commercial St
Leavenworth, WA 98826-1316
Phone (509) 548-3420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00036435WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No. 1 CurrentSince Sep 12, 2000 Accepting new patients
Chelan County Public Hospital District No. 1 Current Accepting new patients
Chelan County Public Hospital District No. 1 CurrentSince Sep 12, 2000 Accepting new patients

Locations

817 Commercial St
Leavenworth, WA 98826
Phone (509) 548-3420

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1316941727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-3420",
            "fax_number": "509-548-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-3420",
            "fax_number": "509-548-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "GEOFFREY",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00036435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8232449",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, WA

Sources for this page

Verify at the official NPI Registry.