Active NPI
Genevieve Mari Richardson
- Contractor
- Pueblo, CO
National Provider Identifier
1770829954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 995885
- Practice address
- 221 S Union Ave
Pueblo, CO 81003-3490 - Phone
- (719) 545-1114
- NPI assigned
- Dec 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 995885 | CO | Primary |
Addresses
Primary practice location
221 S Union Ave
Pueblo, CO 81003-3490
Mailing address
508 S Pin High CT
Pueblo West, CO 81007-6049
Phone (719) 924-3796
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 995885 | CO | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355702400000",
"number": "1770829954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 S PIN HIGH CT",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810076049",
"telephone_number": "719-924-3796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 S UNION AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033490",
"telephone_number": "719-545-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "GENEVIEVE",
"middle_name": "MARI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-17",
"last_updated": "2012-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CO",
"license": "995885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.