NPIMap

Organization Active NPI

Richardson Martin Incorporated

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1730765884
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
RICHARDSON MARTIN INCORPORATED
Practice address
727 W Hargett St Ste 103
Raleigh, NC 27603-1669
Phone
(919) 803-8038
NPI assigned
Mar 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Mr. Levi Christopher Richardson
Title
Co-Ceo
Phone
(843) 409-0491

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

727 W Hargett St Ste 103
Raleigh, NC 27603-1669

Mailing address

727 W Hargett St Ste 103
Raleigh, NC 27603-1669
Phone (919) 803-8038

Other names 1

  • Mindology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220314000856 NC Part B Supplier - Clinic/Group Practice 1658766431 Receives reassigned benefits from 11 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

727 W Hargett St
Ste 103
Raleigh, NC 27603
Phone (919) 264-4615

727 W Hargett St
Ste 105
Raleigh, NC 27603

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1730765884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 W HARGETT ST STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031669",
            "telephone_number": "919-803-8038",
            "fax_number": "919-882-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W HARGETT ST STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031669",
            "telephone_number": "919-803-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARDSON MARTIN INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "LEVI",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "843-409-0491",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.