NPIMap

Organization Active NPI

Roy W. Richardson, III, D.D.S., P.a.

  • General Practice Dentistry
  • Monroe, NC
National Provider Identifier
1578683876
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ROY W. RICHARDSON, III, D.D.S., P.A.
Practice address
1276 Stafford St
Monroe, NC 28110-3286
Phone
(704) 289-4505
Fax
(704) 283-8654
NPI assigned
Mar 30, 2007
Last updated
May 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Authorized official

Name
Mrs. Andrea Wilkins Shrum
Title
Office Manager
Phone
(704) 289-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1276 Stafford St
Monroe, NC 28110-3286

Mailing address

1276 Stafford St
Monroe, NC 28110-3286
Phone (704) 289-4505

Other identifiers 1

IdentifierTypeStateIssuer
113590OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

1276 Stafford St
Monroe, NC 28110
Phone (704) 289-4505

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1578683876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 STAFFORD ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103286",
            "telephone_number": "704-289-4505",
            "fax_number": "704-283-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 STAFFORD ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103286",
            "telephone_number": "704-289-4505",
            "fax_number": "704-283-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY W. RICHARDSON, III, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "SHRUM",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "WILKINS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-289-4505",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "113590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.