Bethany D Richerson, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004243 Issued in KY

Practice address

165 Natchez Trace Ave
Ste 200
Bowling Green, KY 42103-7940

Phone

(270) 796-4698

Fax

(270) 782-3274

NPI assigned

Dec 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prorehab IncGroup PAC ID 1254317217, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: referral1@prorehab-bowling-green.direct.kno2fy.com

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.

• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509

  KY

  Medicare reassignment Care Compare group NPD
• Prorehab Inc

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1841014933

  Physical Therapist

  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1073501003
  NPD (past)

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1750366175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ TRACE AVE",
            "address_2": "STE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037940",
            "telephone_number": "270-796-4698",
            "fax_number": "270-782-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ TRACE AVE",
            "address_2": "STE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037940",
            "telephone_number": "270-796-4698",
            "fax_number": "270-782-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "BETHANY",
        "middle_name": "D",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007579A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000590928",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000280266",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200839570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dadrion Richardson
• Julie Richardson, LPCA
• Paige Arlene Richardson, OTR/L
• Sarah Elise Richardson
• Sharma Tanisse Richardson, MD
• Emily Richie
• Sarah Leigh Richman, M.S., ATC
• Stephanie Rickard
• Brandon Riddle
• Caitlyn Elizabeth Riggs

• Physical Therapist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.