Individual provider Active NPI

Dakota Richerson, PA-C

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1639960073
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone
(812) 676-4500
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004895A IN
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1520 S Liberty Dr
Bloomington, IN 47403-5167

Mailing address

1456 Rogers Rd
West Frankfort, IL 62896-5452

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dricherson@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20251022000974 IN Practitioner - Physician Assistant 2466940465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians

Practice addresses (Care Compare)

1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone (888) 484-3258

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10004895AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant CurrentSince Oct 1, 2025 Accepting new patients

Locations

1520 S Liberty Dr
Bloomington, IN 47403
Phone (812) 676-4300

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: dricherson@direct.iuhealth.org

Organizations & group practices 3

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 1

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": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1639960073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 ROGERS RD",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628965452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-676-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "DAKOTA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004895A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dricherson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1520 S Liberty Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.