Active NPI
Kendra Bernitta Richardson
- Social Worker
- Fort Benning, GA
National Provider Identifier
1376017988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4222G
- Practice address
- 6600 Van Aalst Blvd
Fort Benning, GA 31905-2102 - Phone
- (706) 544-2273
- NPI assigned
- Jan 16, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 4222G | AL | Primary |
Addresses
Primary practice location
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Mailing address
57 Lee Road 2212
Smiths Station, AL 36877-3392
Phone (256) 653-6340
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 |
|---|---|---|---|
| 4222G | AL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1376017988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 LEE ROAD 2212",
"city": "SMITHS STATION",
"state": "AL",
"postal_code": "368773392",
"telephone_number": "256-653-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD",
"city": "FORT BENNING",
"state": "GA",
"postal_code": "319052102",
"telephone_number": "706-544-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KENDRA",
"middle_name": "BERNITTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AL",
"license": "4222G",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.