NPIMap

Organization Active NPI

John W Richardson MD PA

  • Family Medicine Physician
  • Decatur, TX
National Provider Identifier
1376589408
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHN W RICHARDSON MD PA
Practice address
2301 S FM 51
Suite 500
Decatur, TX 76234-3865
Phone
(940) 627-0013
Fax
(940) 627-1900
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
John W Richardson, MDNPI 1659311850
Title
President
Phone
(940) 627-0013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X

Addresses

Primary practice location

2301 S FM 51
Suite 500
Decatur, TX 76234-3865

Mailing address

2301 S FM 51
Suite 500
Decatur, TX 76234-3865
Phone (940) 627-0013

Other identifiers 3

IdentifierTypeStateIssuer
168598401MedicaidTX
0080QJOtherTXBCBS
DC0267OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041026001147 TX Part B Supplier - Clinic/Group Practice 1456312032 Receives reassigned benefits from 4 practitioners
Practice locations: Decatur, TX

National Provider Directory

National Provider Directory

Locations

2301 S FM 51
Decatur, TX 76234
Phone (940) 627-0009

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1376589408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S FM 51",
            "address_2": "SUITE 500",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343865",
            "telephone_number": "940-627-0013",
            "fax_number": "940-627-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S FM 51",
            "address_2": "SUITE 500",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343865",
            "telephone_number": "940-627-0013",
            "fax_number": "940-627-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W RICHARDSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-627-0013",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168598401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0080QJ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC0267",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.