Individual provider Active NPI

Cory M Richards, M.A. CCC-A

  • Audiologist
  • Bend, OR
National Provider Identifier
1629241583
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
22886 Issued in OR
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
500612502MedicaidOR

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

LicenseStateTypeSpecialty
22886ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Jun 26, 2018 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.

Verify at the official NPI Registry.