NPIMap

Individual provider Active NPI

Mark E Richardson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Louisville, KY
National Provider Identifier
1639107261
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
21630 Issued in KY
Practice address
4000 Kresge Way
Pathology Dept
Louisville, KY 40207-4605
Phone
(502) 897-8226
Fax
(502) 897-8215
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 21630 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Pathology Dept
Louisville, KY 40207-4605

Mailing address

1169 Eastern Pkwy
Suite G 71
Louisville, KY 40217-1417
Phone (502) 456-6217

Other identifiers 11

IdentifierTypeStateIssuer
000000062182OtherKYANTHEM BL CROSS BL SHIELD
220020761OtherRAILROAD MEDICARE
1100181OtherKYUNITED HEALTHCARE
31155000400OtherOHWORKERS COMP OHIO
6598690OtherKYCIGNA HEALTHCARE
100373830AOtherINMEDICAID INDIANA
2432721000OtherKYPASSPORT ADVANTAGE
104509OtherKYHEALTH PARTNERS
1049932OtherKYMEDICAID PASSPORT
64216302MedicaidKY
124519600OtherFLWORKERS COMP FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100226000868 KY Practitioner - Pathology 4385789544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Louisville School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Associates LLCGroup PAC ID 3577456300, 28 clinicians

Practice addresses (Care Compare)

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 897-9594

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Norton-King'S Daughters' Health Hospital, Madison, IN, CCN 150069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21630KYMDAnatomic Pathology & Clinical Pathology Physician

Interoperability endpoints

  • Direct secure messaging: mrichardson182864@direct.nortonhealthcare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1639107261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "SUITE G 71",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171417",
            "telephone_number": "502-456-6217",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "address_2": "PATHOLOGY DEPT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8226",
            "fax_number": "502-897-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "21630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BL CROSS BL SHIELD",
            "identifier": "000000062182",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220020761",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1100181",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP OHIO",
            "identifier": "31155000400",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "6598690",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID INDIANA",
            "identifier": "100373830A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432721000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "104509",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PASSPORT",
            "identifier": "1049932",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64216302",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP FLORIDA",
            "identifier": "124519600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.