James M. Richardson, Jr., D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

2547 Issued in SC

Practice address

804 W Main St
Lake City, SC 29560-4400

Phone

(843) 374-8010

Fax

(843) 374-2030

NPI assigned

Oct 11, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lake City Family Dentistry

  • Dentist
  • Lake City, SC
  • NPI 1689710139
  NPD (past)
• Lake City Family Dentistry

  • Dentist
  • Lake City, SC
  • NPI 1770671968
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629166889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 W MAIN ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295604400",
            "telephone_number": "843-374-8010",
            "fax_number": "843-374-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 W MAIN ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295604400",
            "telephone_number": "843-374-8010",
            "fax_number": "843-374-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON, JR.",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "2547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZ2547",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lake City, SC
• Providers in Lake City, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.