Matthew Dale Richardson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10240 Issued in FL

Practice address

4705 S Clyde Morris Blvd
Port Orange, FL 32129-4103

Phone

(386) 763-2718

Fax

(386) 763-2719

NPI assigned

Apr 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Palmer College Foundation

  dba Palmer College of Chiropractic Florida

  • Chiropractor
  • Port Orange, FL
  • NPI 1568552255
  Medicare reassignment NPD
• Palmer College Foundation

  dba Palmer Chiropractic Clinic

  • Chiropractor
  • Davenport, IA
  • NPI 1174535181
  NPD

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1710204219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 S CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 S CLYDE MORRIS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294103",
            "telephone_number": "386-763-2718",
            "fax_number": "386-763-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MATTHEW",
        "middle_name": "DALE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Ribbink, RDMS
• Donato R Ricci, MD
• Morgan Rice
• Richard Polhill Professional Hearing Solutions, LLC
• Christy Anne Richard, RN
• Katherine Riddle
• Joanne Plumb Rieger, COTA
• Kathleen Rill
• Ashlyn Ring
• Laura Ringler

• Chiropractor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.