Individual provider Active NPI

Thomas L Richardson, MD

  • Family Medicine Physician
  • Richland Center, WI
National Provider Identifier
1669473286
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23207 Issued in WI
Practice address
301 E 2ND St
Richland Center, WI 53581-1900
Phone
(608) 647-6161
Fax
(608) 647-3178
NPI assigned
Aug 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23207 WI Primary

Addresses

Primary practice location

301 E 2ND St
Richland Center, WI 53581-1900

Mailing address

301 E 2ND St
Richland Center, WI 53581-1900
Phone (608) 647-6161

Other identifiers 3

IdentifierTypeStateIssuer
0852480001OtherWIDMERC
30356100MedicaidWI
528514OtherWIUGS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050827000119 WI Practitioner - Family Practice 7315831328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1669473286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-6161",
            "fax_number": "608-647-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-6161",
            "fax_number": "608-647-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "23207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0852480001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30356100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UGS MEDICARE",
            "identifier": "528514",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.