Active NPI
Thomas Richards, M.D.
- Family Medicine Physician
- Burns, OR
National Provider Identifier
1710104351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD15123
- Practice address
- 557 W Washington St
Burns, OR 97720-1441 - Phone
- (541) 573-7281
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD15123 | OR | Primary |
Addresses
Primary practice location
557 W Washington St
Burns, OR 97720-1441
Mailing address
334 Susan Dr.
Moscow, ID 83843-9482
Phone (208) 596-1662
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1201778 | Medicaid | WY | |
| 156158 | Medicaid | OR | |
| P00059941 | Other | RR MEDICARE | |
| 80649700 | Medicaid | ID | |
| 8300121 | Medicaid | WA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15123 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Footcare, LLC | Past | Accepting new patients |
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.
-
- Podiatrist
- Bend, OR
- NPI 1275545311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710104351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 SUSAN DR.",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838439482",
"telephone_number": "208-596-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "557 W WASHINGTON ST",
"city": "BURNS",
"state": "OR",
"postal_code": "977201441",
"telephone_number": "541-573-7281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "THOMAS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD15123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1201778",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "156158",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00059941",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80649700",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8300121",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burns, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.