Individual provider Active NPI

Alysse Coravon Richardson, D.C.

  • Chiropractor
  • Miami, FL
National Provider Identifier
1659794733
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11040 Issued in FL
Practice address
671 NW 119TH St
Miami, FL 33168-2522
Phone
(305) 688-0811
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11040 FL Primary

Addresses

Primary practice location

671 NW 119TH St
Miami, FL 33168-2522

Mailing address

671 NW 119TH St
Miami, FL 33168-2522
Phone (305) 688-0811

Other practice location 1

1756 N Bayshore Dr
Apt 30G
Miami, FL 33132-1132
Phone (267) 257-6011

Other identifiers 1

IdentifierTypeStateIssuer
020665100MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
CH 11040FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1659794733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 NW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331682522",
            "telephone_number": "305-688-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 NW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331682522",
            "telephone_number": "305-688-0811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1756 N Bayshore Dr",
            "address_2": "Apt 30G",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331321132",
            "country_code": "US",
            "telephone_number": "267-257-6011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "ALYSSE",
        "middle_name": "CORAVON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020665100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.