Individual provider Active NPI

Richard L Caudell, DPM

  • Podiatrist
  • Colonial Heights, VA
National Provider Identifier
1497755136
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000442 Issued in VA
Practice address
3660 Boulevard
Ste B
Colonial Heights, VA 23834-1345
Phone
(804) 520-4144
Fax
(804) 520-4144
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103000442 VA Primary

Addresses

Primary practice location

3660 Boulevard
Ste B
Colonial Heights, VA 23834-1345

Mailing address

3660 Boulevard
Ste B
Colonial Heights, VA 23834-1345
Phone (804) 520-4144

Other identifiers 1

IdentifierTypeStateIssuer
009301569MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1497755136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 BOULEVARD",
            "address_2": "STE B",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341345",
            "telephone_number": "804-520-4144",
            "fax_number": "804-520-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 BOULEVARD",
            "address_2": "STE B",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341345",
            "telephone_number": "804-520-4144",
            "fax_number": "804-520-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDELL",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.