Individual provider Active NPI

Richard Kirk Welsh, D.O.

  • Family Medicine Physician
  • Banning, CA
National Provider Identifier
1710988563
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5620 Issued in CA
Practice address
Riverside-San Bernardino County Indian Health, Inc.
11555 1/2 Potrero Rd.
Banning, CA 92220
Phone
(951) 849-4761
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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 20A5620 CA Primary

Addresses

Primary practice location

Riverside-San Bernardino County Indian Health, Inc.
11555 1/2 Potrero Rd.
Banning, CA 92220

Mailing address

41133 Marseille CT
Murrieta, CA 92562-1976
Phone (951) 677-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160413001288 TX Practitioner - Family Practice 5395971196 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Mar 16, 2016 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Mar 16, 2016 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients

Locations

11555 Potrero Rd
Banning, CA 92220
Phone (800) 732-8805

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1710988563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41133 MARSEILLE CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925621976",
            "telephone_number": "951-677-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.",
            "address_2": "11555 1/2 POTRERO RD.",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "92220",
            "telephone_number": "951-849-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSH",
        "first_name": "RICHARD",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.