Kelly A. Richardson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02363 Issued in TX

Practice address

2830 Calder St
Beaumont, TX 77702-1809

Phone

(409) 781-1014

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Kelly A. Wheeler Other name

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Gulf Coast Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Alice, TX
  • NPI 1972286920
  Medicare reassignment
• Jasper Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Jasper, TX
  • NPI 1922781970
  Medicare reassignment
• Jefferson Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1609559699
  Medicare reassignment
• Sound Physicians Emergency Medicine of Texas PLLC

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1518475557
  Medicare reassignment
• Preventive Medicine of Southeast Texas, LLP

  • Family Medicine Physician
  • Beaumont, TX
  • NPI 1013928290
  NPD (past)
• Southeast Emergency Physician Associates, P.a.

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1235155102
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1831248715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 RIDGELAND ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777064510",
            "telephone_number": "409-781-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021809",
            "telephone_number": "409-781-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KELLY",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88N836",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WHEELER",
            "middle_name": "A.",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Richard
• Romona Harrison Richard, MSN APRN-BC
• Breanna Richards, COTA/L
• Karlee Elizabeth Richards, MS CCC-SLP
• Katie Charlotte Richardson
• Monica Richardson
• Brittany Nicole Richmond, REGISTERED NURSE
• Ashton Richter, MS, CCC-SLP
• Rick L Evans MD PA
• Amber Elizabeth Riedel, LCDC

• Physician Assistant in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.