Active NPI
Alysse Coravon Richardson, D.C.
- Chiropractor
- Miami, FL
National Provider Identifier
1659794733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH 11040
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020665100 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CH 11040 | FL | MD | Chiropractor |
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.