Keri Lynn Richardson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2908 Issued in AZ

Practice address

10930 N Tatum Blvd
Ste 103
Phoenix, AZ 85028-6069

Phone

(602) 263-7600

Fax

(602) 212-0365

NPI assigned

Sep 7, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Keri Lynn Mullin Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
• Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Az Richardson Surgical Services, LLC

  • Surgical Physician Assistant
  • Scottsdale, AZ
  • NPI 1679826051
  Medicare reassignment Authorized official
• Rex Hospital, Inc.

  • Nutrition Education Nutritionist
  • Raleigh, NC
  • NPI 1821472572
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1386608859
  Care Compare affiliation

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1447244355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 N TATUM BLVD",
            "address_2": "STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286069",
            "telephone_number": "602-263-7600",
            "fax_number": "602-212-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 N TATUM BLVD",
            "address_2": "STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286069",
            "telephone_number": "602-263-7600",
            "fax_number": "602-212-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KERI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "MULLIN",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elise Faye Richardson, DPT
• Gregory Willett Richardson
• Hailey B Richardson
• Jordan Richardson, DPM
• Keighley Faye Richardson, PA-C, ATC
• Kitty Lee Richardson
• Landon C Richardson, DNP
• Leesha Nicole Richardson, AGNP-C
• Logan Richardson, OTR/L
• Mark Richardson, FNP-C

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.