David Paul Richardson Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA202759 Issued in OR

Practice address

2924 Siskiyou Blvd Ste 200
Medford, OR 97504-6462

Phone

(541) 200-2777

Fax

(541) 214-2575

NPI assigned

Oct 30, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

K Wade Foster MD PAGroup PAC ID 3173663374, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: drichardson@centralflderm.emadirect.md

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.

• K Wade Foster MD PA

  • MOHS-Micrographic Surgery Physician
  • Winter Haven, FL
  • NPI 1205066404
  Medicare reassignment Care Compare group
• Michael J Freeman MD PA

  • Dermatology Physician
  • Ocala, FL
  • NPI 1801083589
  Medicare reassignment
• Northwest Eye & Skin Surgeons Inc PS

  • Dermatology Physician
  • Sequim, WA
  • NPI 1699947200
  Medicare reassignment
• Lumen Dermatology LLC

  • Dermatology Physician
  • Lady Lake, FL
  • NPI 1235938341
  NPD (past)
• Skin Cancer Center of North Georgia PC

  • MOHS-Micrographic Surgery Physician
  • Blue Ridge, GA
  • NPI 1265205488
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1447622345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 SISKIYOU BLVD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046462",
            "telephone_number": "541-200-2777",
            "fax_number": "541-214-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 SISKIYOU BLVD STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046462",
            "telephone_number": "541-200-2777",
            "fax_number": "541-214-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2022-10-13",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA202759",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60606167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Joseph Rich
• Richard C Schmidt
• Karen B Richards, DMD - PERIODONTIST
• Amber Richardson, LMT 20105
• Carl Richardson, QMHA
• Laurena Diane Richardson, PA-C
• Ryleah A Richardson, BAI
• Toni Richmond, LMFT
• Lisa Elizabeth Richner
• Wendy Richter-Roberts, BA

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.