Individual provider Active NPI

David Clifford Richardson, AU.D.

  • Audiologist
  • Statesville, NC
National Provider Identifier
1427152123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6376 Issued in NC
Practice address
707 Bryant St
Statesville, NC 28677
Phone
(704) 873-5224
Fax
(704) 873-5984
NPI assigned
Sep 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 6376 NC Primary

Addresses

Primary practice location

707 Bryant St
Statesville, NC 28677

Mailing address

707 Bryant St
Statesville, NC 28677
Phone (704) 873-5224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080924000141 NC Practitioner - Qualified Audiologist 8820165426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

707 Bryant St
Statesville, NC 28677-4142
Phone (704) 873-5224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6376NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Aug 20, 2008 Accepting new patients
Piedmont Healthcare, P.a. CurrentSince Aug 20, 2008 Accepting new patients

Locations

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

707 Bryant St
Statesville, NC 28677
Phone (704) 873-5224

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427152123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BRYANT ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28677",
            "telephone_number": "704-873-5224",
            "fax_number": "704-873-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BRYANT ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28677",
            "telephone_number": "704-873-5224",
            "fax_number": "704-873-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DAVID",
        "middle_name": "CLIFFORD",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "6376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.