NPIMap

Individual provider Active NPI

Steven G Richardson, MD

  • Family Medicine Physician
  • Sandy, UT
National Provider Identifier
1629030838
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11809415-1205 Issued in UT
Practice address
1403 E Sego Lily Dr
Sandy, UT 84092-4350
Phone
(801) 316-9620
NPI assigned
Apr 4, 2006
Last updated
Jun 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11809415-1205 UT Primary

Addresses

Primary practice location

1403 E Sego Lily Dr
Sandy, UT 84092-4350

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (801) 316-9620

Other identifiers 5

IdentifierTypeStateIssuer
0104083OtherOHUHC
P00013823OtherOHRRM
000000286657OtherOHBCBS
2172830MedicaidOH
141867207026OtherOHCARESOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210107002513 UT Practitioner - Family Practice 6406877000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Ridge Family Medicine LLCGroup PAC ID 8820091473, 10 clinicians

Practice addresses (Care Compare)

6321 S Redwood Rd
Suite 201
Taylorsville, UT 84123-6972
Phone (702) 480-2550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11809415-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group P a Family Medicine CurrentSince Sep 15, 2020 Accepting new patients
Jordan Ridge Family Medicine LLC Family Medicine CurrentSince Sep 15, 2020 Accepting new patients
Jordan Ridge Family Medicine LLC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Jordan Ridge Family Medicine LLC CurrentSince Feb 1, 2021 Accepting new patients
Allergy and Asthma Center, Inc PastSince Jul 1, 2017 Accepting new patients
Madison Family Health Corporation Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1403 E Sego Lily Dr
Sandy, UT 84092
Phone (801) 265-2212

1403 E Sego Lily Dr
#100B
Sandy, UT 84092
Phone (801) 316-9620

6321 S Redwood Rd
Ste 201
Taylorsville, UT 84123
Phone (801) 265-2212

4071 S 4000 W
West Valley City, UT 84120
Phone (801) 265-0103

Interoperability endpoints

  • Direct secure messaging: srichardson114327@westdirect.optum.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1629030838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "801-316-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 E SEGO LILY DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924350",
            "telephone_number": "801-316-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "STEVEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11809415-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0104083",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "P00013823",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000286657",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2172830",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "141867207026",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.