Renee Marie Richardson, PT,MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4452 Issued in GA

Practice address

1603 Georgia Highway 20 NE
Conyers, GA 30012-3945

Phone

(770) 929-8411

Fax

(770) 918-1419

NPI assigned

Sep 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Occupational Health Centers of Georgia PC

  • Occupational Medicine Clinic/Center
  • Marietta, GA
  • NPI 1306855838
  NPD (past)
• Occupational Health Centers of Georgia PC

  • Occupational Medicine Clinic/Center
  • Morrow, GA
  • NPI 1417296948
  NPD (past)

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1700071255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 GEORGIA HIGHWAY 20 NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123945",
            "telephone_number": "770-929-8411",
            "fax_number": "770-918-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 GEORGIA HIGHWAY 20 NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123945",
            "telephone_number": "770-929-8411",
            "fax_number": "770-918-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT,MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "4452",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "T6330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicklaus Trent Rice, M.D.
• Venesa Richards-Johnson, APRN
• Brittany Richardson
• Bruce Walter Richardson
• Jonae Perrin Richardson, PA-C
• Cheryl Hermione Richmond, M.D.
• Cheryl L Riley, IBCLC
• Jessica Rios-Jones, ED.D
• Rising Phoenix Health and Wellness Empowerment Center, LLC
• Jorge E Rivera-Kolb, M.D.

• Physical Therapist in Conyers, GA
• Providers in Conyers, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.