Jacob A Richardson, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002

Phone

(262) 532-3700

NPI assigned

Apr 23, 2024

Last updated

Apr 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1609621481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W180N8000 TOWN HALL RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N8000 TOWN HALL RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514002",
            "telephone_number": "262-532-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Paul Revolinski, M.D.
• Jeffrey Donald Rhody, DDS
• Sarah Joehl Richards, OTR
• Airron Lamar Richardson, M.D.
• Amanda Richardson, H.I.S.
• Werner Richheimer, DDS
• Julie Lewis Rickert, PSYD
• Ridgeview Dental Group SC
• Riesch Surgical Science LLC
• Terrence John Riesch, D.D.S.

• Student in an Organized Health Care Education/Training Program in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.