Active NPI
Bennett Richter, MS, LAT, ATC
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Carmi, IL
National Provider Identifier
1487334249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 096.005655
- Practice address
- 914 County Road 1500 E
Carmi, IL 62821-5610 - Phone
- (618) 616-0228
- NPI assigned
- Jul 18, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 096.005655 | IL | Primary |
Addresses
Primary practice location
914 County Road 1500 E
Carmi, IL 62821-5610
Mailing address
914 County Road 1500 E
Carmi, IL 62821-5610
Phone (618) 616-0228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.005655 | IL | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1487334249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 COUNTY ROAD 1500 E",
"city": "CARMI",
"state": "IL",
"postal_code": "628215610",
"telephone_number": "618-616-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 COUNTY ROAD 1500 E",
"city": "CARMI",
"state": "IL",
"postal_code": "628215610",
"telephone_number": "618-616-0228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHTER",
"first_name": "BENNETT",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-18",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "IL",
"license": "096.005655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmi, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.