Individual provider Active NPI

Christina Marie Richards, NP- C

  • Nurse Practitioner
  • Bend, OR
National Provider Identifier
1659027803
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
202208609NP-PP Issued in OR
Practice address
2088 NE Kim LN
Bend, OR 97701-6588
Phone
(541) 504-6010
NPI assigned
Feb 25, 2022
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 202208609NP-PP OR Primary
Family Nurse Practitioner 363LF0000X 95020136 CA

Addresses

Primary practice location

2088 NE Kim LN
Bend, OR 97701-6588

Mailing address

3265 Hillcrest Park Dr
Medford, OR 97504-7657

Other names 1

  • Christina Desouza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220725000963 OR Practitioner - Nurse Practitioner 3173901212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nexus Wound Consultants LLCGroup PAC ID 7416489828, 2 clinicians

Practice addresses (Care Compare)

780 Commercial St SE
Suite 100
Salem, OR 97301-3465
Phone (830) 285-8882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202208609NP-PPORMDNurse Practitioner
95020136CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nexus Wound Consultants LLC Single Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: christina.richards@115443077021700.direct.elationemr.com

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1659027803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 HILLCREST PARK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 NE KIM LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016588",
            "telephone_number": "541-504-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "NP- C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202208609NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DESOUZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.