Individual provider Active NPI

Leah Kathryn Richardson, FNP-BC

  • Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1407341233
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71008163A Issued in IN
Practice address
213 Middlebury St
Goshen, IN 46528
Phone
(574) 534-3300
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28204011A IN
Nurse Practitioner 363L00000X 71008163A IN Primary

Addresses

Primary practice location

213 Middlebury St
Goshen, IN 46528

Mailing address

213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-3300

Other practice location 1

808 N 3rd St
Goshen, IN 46528-7100
Phone (574) 534-0088

Other identifiers 1

IdentifierTypeStateIssuer
300017737MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lrichardson299544@direct.ochin.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180919001628 IN Practitioner - Nurse Practitioner 1658622345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28204011AINMDRegistered Nurse
71008163AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maple City Health Care Center, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Maple City Health Care Center, Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

808 N 3rd St
Goshen, IN 46528
Phone (574) 534-0088

2606 Peddlers Village Rd
Ste 210
Goshen, IN 46526
Phone (260) 602-3276

213 Middlebury St
Goshen, IN 46528
Phone (574) 534-0088

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1407341233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MIDDLEBURY ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465282956",
            "telephone_number": "574-534-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 MIDDLEBURY ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "46528",
            "telephone_number": "574-534-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465287100",
            "country_code": "US",
            "telephone_number": "574-534-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LEAH",
        "middle_name": "KATHRYN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28204011A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008163A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300017737",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrichardson299544@direct.ochin.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "213 Middlebury St",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.