Individual provider Active NPI

Lisa E Richards, P.A.-C

  • Medical Physician Assistant
  • Clare, MI
National Provider Identifier
1639155732
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004348 Issued in MI
Practice address
700 W 5TH St
Clare, MI 48617-9414
Phone
(989) 386-9911
Fax
(989) 386-9913
NPI assigned
Dec 20, 2005
Last updated
Sep 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004348 MI Primary

Addresses

Primary practice location

700 W 5TH St
Clare, MI 48617-9414

Mailing address

700 W 5TH St
Clare, MI 48617-9414
Phone (989) 386-9911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000151 MI Practitioner - Physician Assistant 5193773331 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center ClareGroup PAC ID 7012829773, 128 clinicians

Practice addresses (Care Compare)

1105 E Cedar Ave
Gladwin, MI 48624-7003
Phone (989) 246-6490

335 E Houghton Ave
West Branch, MI 48661-1127
Phone (989) 345-8130

515 Quarter St
Gladwin, MI 48624-1959
Phone (989) 426-9286

602 Beech St
Clare, MI 48617-1466
Phone (989) 802-5117

602 Beech St
Suite 1100
Clare, MI 48617-1476
Phone (989) 386-9911

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Oct 1, 2016 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Aug 13, 2008 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Oct 1, 2016 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Oct 1, 2016 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Oct 1, 2016 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Oct 1, 2016 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Oct 1, 2016 Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

9249 W Lake City Rd
Houghton Lake, MI 48629
Phone (989) 422-2183

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

Interoperability endpoints

  • Direct secure messaging: lrichards6880@mymichiganhealth.midirect.net

Organizations & group practices 9

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 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1639155732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W 5TH ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486179414",
            "telephone_number": "989-386-9911",
            "fax_number": "989-386-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 5TH ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486179414",
            "telephone_number": "989-386-9911",
            "fax_number": "989-386-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

Verify at the official NPI Registry.