Individual provider Active NPI

Daveisha Jalynn Richardson

  • Family Nurse Practitioner
  • Orangeburg, SC
National Provider Identifier
1568202869
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29811 Issued in SC
Practice address
755 Whitman St
Orangeburg, SC 29115-6163
Phone
(803) 534-7036
NPI assigned
May 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29811 SC Primary

Addresses

Primary practice location

755 Whitman St
Orangeburg, SC 29115-6163

Mailing address

5997 Carolina Highway
Denmark, SC 29042
Phone (803) 308-4716

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

State licenses

LicenseStateTypeSpecialty
29811SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1568202869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5997 CAROLINA HIGHWAY",
            "city": "DENMARK",
            "state": "SC",
            "postal_code": "29042",
            "telephone_number": "803-308-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WHITMAN ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291156163",
            "telephone_number": "803-534-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DAVEISHA",
        "middle_name": "JALYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.