Active NPI
Donald Richardson, M.D.
- Internal Medicine Physician
- Saint Louis, MO
National Provider Identifier
1700867215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R6979
- Practice address
- 12345 W Bend Dr
Suite 300
Saint Louis, MO 63128-2182 - Phone
- (314) 849-6000
- Fax
- (314) 849-1417
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | R6979 | MO | |
| Internal Medicine Physician | 207R00000X | R6979 | MO | Primary |
Addresses
Primary practice location
12345 W Bend Dr
Suite 300
Saint Louis, MO 63128-2182
Mailing address
PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 849-6000
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4214916 | Other | MO | AETNA |
| 000000010031 | Other | MO | ESSENCE |
| 9184 | Other | MO | BCBS |
| 201659414 | Medicaid | MO | |
| A10039 | Other | MO | MERCY |
| 127486 | Other | MO | GHP |
| 0400272 | Other | MO | UHC |
| 114793 | Other | MO | HEALTHLINK |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Multispecialty Group Inc. | Internal Medicine | Current | Accepting new patients |
Locations
5034 Griffin Rd
Saint Louis, MO 63128
Phone (314) 645-3743
12345 W Bend Dr
Ste 300
Saint Louis, MO 63128
Phone (314) 849-6000
9930 Watson Rd
Saint Louis, MO 63126
Phone (314) 984-8827
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1972559532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1700867215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23340",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631563340",
"telephone_number": "314-849-6000",
"fax_number": "314-849-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12345 W BEND DR",
"address_2": "SUITE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282182",
"telephone_number": "314-849-6000",
"fax_number": "314-849-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "DONALD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MO",
"license": "R6979",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R6979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4214916",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ESSENCE",
"identifier": "000000010031",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "9184",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201659414",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "A10039",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "127486",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "0400272",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "114793",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
- Rahnika Rochelle Richardson Jones
- Andrea Richardson, CFSD
- Brittany Elaine Richardson, PNP
- Daniel J Richardson, C-AA
- Daphne Lavette Richardson
- Donald Glenn Richardson, DMD
- Gemecia Patrice Richardson, RN
- Hannah Nicole Richardson, FNP-BC
- Jacqueline Sarah Richardson, L.C.S.W.
- Jonah Richardson, RD, RDN, LD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.