Individual provider Active NPI

Brent Richardson

  • Surgery Physician
  • Wolfeboro, NH
National Provider Identifier
1407241805
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20505 Issued in NH
Practice address
240 S Main St
Wolfeboro, NH 03894-4411
Phone
(603) 569-7500
NPI assigned
Apr 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20505 NH Primary
Surgery Physician 208600000X TRN21762 FL

Addresses

Primary practice location

240 S Main St
Wolfeboro, NH 03894-4411

Mailing address

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-3903

Other practice location 1

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-4835

Other identifiers 1

IdentifierTypeStateIssuer
3123567MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20201105001962 NH Practitioner - General Surgery 7911204052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 2365418993, 79 clinicians

Practice addresses (Care Compare)

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20505NHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital CurrentSince Jan 23, 2026 Accepting new patients
Memorial Hospital Surgery CurrentSince Jun 28, 2024 Accepting new patients
Memorial Hospital CurrentSince Jun 28, 2024 Accepting new patients
Catholic Medical Center Current Accepting new patients

Locations

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

240 S Main St
Wolfeboro, NH 03894
Phone (603) 515-2093

Interoperability endpoints

  • Direct secure messaging: brentrichardson@gohnh.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1407241805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S MAIN ST",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038944411",
            "telephone_number": "603-569-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 White Mountain Hwy",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038607101",
            "country_code": "US",
            "telephone_number": "603-356-4835",
            "fax_number": "603-356-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "20505",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "TRN21762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3123567",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolfeboro, NH

Sources for this page

Verify at the official NPI Registry.