Individual provider Active NPI

Patrice Ava-Dawn Richardson, N.P.

  • Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1790821064
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
232168 Issued in MA
Practice address
2003 Medical Pkwy
102
Annapolis, MD 21401-7992
Phone
(443) 481-1000
Fax
(443) 481-1687
NPI assigned
Jan 30, 2007
Last updated
Dec 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 232168 MA Primary
Adult Health Nurse Practitioner 363LA2200X 232168 MA

Addresses

Primary practice location

2003 Medical Pkwy
102
Annapolis, MD 21401-7992

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160120000509 MD Practitioner - Nurse Practitioner 9537267349 Reassigns benefits to 2 organizations
I20201102000261 DC Practitioner - Nurse Practitioner 9537267349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

90 Ritchie Hwy
Pasadena, MD 21122-4303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
232168MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Dec 1, 2016 Accepting new patients
Hospice of the Chesapeake, Inc CurrentSince Aug 18, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Dec 1, 2016 Accepting new patients
Hospice of the Chesapeake, Inc CurrentSince Aug 18, 2020 Accepting new patients
Bernard a Westerling III, MD, LLC Past Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Coordinated Primary Care, Inc. Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 102
Annapolis, MD 21401
Phone (410) 573-9511

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

90 Ritchie Hwy
Pasadena, MD 21122
Phone (410) 987-2003

Organizations & group practices 9

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1790821064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6560",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MEDICAL PKWY",
            "address_2": "102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017992",
            "telephone_number": "443-481-1000",
            "fax_number": "443-481-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "PATRICE",
        "middle_name": "AVA-DAWN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "232168",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "232168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.