Nicole Joan Richardson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31007705A Issued in IN

Practice address

2121 Willow St
Vincennes, IN 47591-5355

Phone

(812) 882-1141

Fax

(812) 255-0045

NPI assigned

Jan 22, 2020

Sex

Female

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 IN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prorehab IncGroup PAC ID 1254317217, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451

  Occupational Therapist

  Medicare reassignment NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1073501003
  Medicare reassignment NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Lafayette, IN
  • NPI 1316210487
  NPD
• Prorehab Inc

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1841014933

  Occupational Therapist

  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1699414961
  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Physical Therapist
  • Evansville, IN
  • NPI 1730357237

  Occupational Therapist

  NPD
• Midwest Children'S Therapy, PLLC

  • Physical Therapist
  • East Peoria, IL
  • NPI 1881466738

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1568092203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165629",
            "telephone_number": "502-882-9379",
            "fax_number": "502-805-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 WILLOW ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475915355",
            "telephone_number": "812-882-1141",
            "fax_number": "812-255-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Carver Ln",
            "address_purpose": "LOCATION",
            "city": "East Peoria",
            "state": "IL",
            "postal_code": "616113052",
            "country_code": "US",
            "telephone_number": "309-282-6704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5533 N Galena Rd",
            "address_purpose": "LOCATION",
            "city": "Peoria Heights",
            "state": "IL",
            "postal_code": "616164447",
            "country_code": "US",
            "telephone_number": "309-682-5428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "NICOLE",
        "middle_name": "JOAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013428",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007705A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.