Will Richardson MD PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME94167 Issued in FL

Legal business name

WILL RICHARDSON MD PA

Doing business as

Natura Dermatology & Cosmetics

Practice address

1120 Bayview Dr
Fort Lauderdale, FL 33304-2505

Phone

(954) 537-4106

Fax

(954) 537-4186

NPI assigned

Oct 5, 2006

Organization subpart

Yes

Parent organization

WILL RICHARDSON, M.D.As reported in NPPES

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

Authorized official

Name

Dr. Willie Forrest Richardson Jr., MDNPI 1043328230

Title

Sole Proprietor

Phone

(954) 537-4106

Specialties & licenses 1

Addresses

Other names 1

• Natura Dermatology & Cosmetics Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Will Richardson MD PA

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Willie Forrest Richardson Jr., MD

  • Dermatology Physician
  • Fort Lauderdale, FL
  • NPI 1043328230
  Medicare reassignment Care Compare group NPD Authorized official
• Blair Andrew Ferguson, ARNP

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
  • NPI 1033771787
  Medicare reassignment Care Compare group NPD
• Alexis Jennings, APRN

  • Dermatology Physician
  • Fort Lauderdale, FL
  • NPI 1962190769
  Medicare reassignment Care Compare group
• Valeria Tina Hidalgo, FNP

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
  • NPI 1245179654
  Medicare reassignment

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1508952458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BAYVIEW DR",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042505",
            "telephone_number": "954-537-4106",
            "fax_number": "954-537-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BAYVIEW DR",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042505",
            "telephone_number": "954-537-4106",
            "fax_number": "954-537-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILL RICHARDSON MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILL RICHARDSON, M.D.",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "FORREST",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "954-537-4106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME94167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natura Dermatology & Cosmetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Nicole Wilbur, APRN
• Chelsea Wilcocks, PSYD
• Eric Christopher Wilkerson, MD
• Natasha Wilkes, FNP-BC
• Shanique E Wilkinson
• William T. Joyner, M.D., P.a.
• Jamila Williams Jenkins
• Imani Ariel Williams-Ephriam, MSW LCSW QS
• Mala Tanya-Sue Williams-Lawrence, LCSW, MSW
• Andrekia Williams-Montgomery, MA, PBT

• Medical Specialty Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.