Active NPI
Cory M Richards, M.A. CCC-A
- Audiologist
- Bend, OR
National Provider Identifier
1629241583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 22886
- Practice address
- 301 NE Franklin Ave
Bend, OR 97701-4917 - Phone
- (541) 389-6669
- Fax
- (541) 389-8865
- NPI assigned
- Apr 10, 2008
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 22886 | OR | Primary |
Addresses
Primary practice location
301 NE Franklin Ave
Bend, OR 97701-4917
Mailing address
301 NE Franklin Ave
Bend, OR 97701-4917
Phone (541) 389-6669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500612502 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22886 | OR | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Current | Accepting new patients |
Locations
301 NE Franklin Ave
Bend, OR 97701
Phone (541) 389-6669
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629241583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 NE FRANKLIN AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977014917",
"telephone_number": "541-389-6669",
"fax_number": "541-389-8865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 NE FRANKLIN AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977014917",
"telephone_number": "541-389-6669",
"fax_number": "541-389-8865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "CORY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "M.A. CCC-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "22886",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500612502",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.