Individual provider Active NPI

Chad Richard, D.C.

  • Chiropractor
  • Lake Charles, LA
National Provider Identifier
1720174170
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
954 Issued in LA
Practice address
Moss Bluff Chiropractic Clinic 119 Tahoe Dr
Lake Charles, LA 70611-5109
Phone
(337) 855-6306
Fax
(337) 855-7012
NPI assigned
Oct 5, 2006
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 954 LA Primary

Addresses

Primary practice location

Moss Bluff Chiropractic Clinic 119 Tahoe Dr
Lake Charles, LA 70611-5109

Mailing address

119 Tahoe Dr
PO Box 12571
Lake Charles, LA 70611-5109
Phone (337) 855-6306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000068 LA Practitioner - Chiropractic 8224206834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moss Bluff Chiropractic ClinicGroup PAC ID 5799953303, 2 clinicians

Practice addresses (Care Compare)

119 Tahoe Dr
Lake Charles, LA 70611-5109
Phone (337) 855-6306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
954LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Moss Bluff Chiropractic Clinic Chiropractor CurrentSince Nov 1, 1999 Accepting new patients

Locations

119 Tahoe Dr
Moss Bluff, LA 70611
Phone (337) 855-6306

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1720174170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 TAHOE DR",
            "address_2": "PO BOX 12571",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115109",
            "telephone_number": "337-855-6306",
            "fax_number": "337-855-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOSS BLUFF CHIROPRACTIC CLINIC 119 TAHOE DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115109",
            "telephone_number": "337-855-6306",
            "fax_number": "337-855-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "CHAD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.