Active NPI
Timothy Richards Jr.
- Occupational Therapist
- Greenville, NC
National Provider Identifier
1770720237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4542
- Practice address
- 1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850 - Phone
- (252) 758-7048
- Fax
- (252) 215-5614
- NPI assigned
- Jan 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4542 | NC | Primary |
| Occupational Therapist | 225X00000X | OT11964 | FL |
Addresses
Primary practice location
1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850
Mailing address
1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850
Phone (252) 758-7048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4542 | Other | NC | NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4542 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Rehabilitation LLC | Past | Accepting new patients | |
| Lifespan Rehabilitation, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Vero Beach, FL
- NPI 1245562057
-
- Physical Disabilities Residential Treatment Facility
- Vero Beach, FL
- NPI 1578884490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1770720237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 E ARLINGTON BLVD",
"address_2": "SUITE A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278587850",
"telephone_number": "252-758-7048",
"fax_number": "252-215-5614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 E ARLINGTON BLVD",
"address_2": "SUITE A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278587850",
"telephone_number": "252-758-7048",
"fax_number": "252-215-5614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "TIMOTHY",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-20",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "4542",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT11964",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY",
"identifier": "4542",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.