Active NPI
Carolyn Marie Richards, PA-C
- Medical Physician Assistant
- Brockway, MI
National Provider Identifier
1346341385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601003614
- Practice address
- 7470 Brockway Rd
Brockway, MI 48097-3458 - Phone
- (810) 387-9355
- NPI assigned
- Sep 25, 2006
- Last updated
- Jul 8, 2007
- 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 | 5601003614 | MI | Primary |
Addresses
Primary practice location
7470 Brockway Rd
Brockway, MI 48097-3458
Mailing address
7696 Metcalf Rd
Greenwood, MI 48006-2726
Phone (810) 387-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110929000700 | MI | Order and Referring Only - Physician Assistant | 4183895873 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003614 | MI | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346341385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7696 METCALF RD",
"city": "GREENWOOD",
"state": "MI",
"postal_code": "480062726",
"telephone_number": "810-387-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7470 BROCKWAY RD",
"city": "BROCKWAY",
"state": "MI",
"postal_code": "480973458",
"telephone_number": "810-387-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601003614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockway, MI
- Melissa Sue Oconnor, RN
- Preston Chiropractic, PLLC (Preston Chiropractic Clinic)
- John Adam Preston, DC
- Prostaff Physical Therapy, PLLC
- Results Chiropractic (Yale Chiropractic Life Center)
- Kelly Marie Ringle
- Renee Ruiz, CPNP
- Katrina Louise Stachowiak, PA-C
- Brianna J Steadman, PA-C
- Tara Lynn Touchette, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.