Tracey Richardson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2013-00205 Issued in NC

Practice address

261 Belvoir Hwy
Greenville, NC 27834-8193

Phone

(252) 695-6352

Fax

(252) 695-6359

NPI assigned

Aug 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI, MT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment NPD
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD
• Premise Health of Montana Medical PC

  dba Montana Anaconda Health Center

  • Multi-Specialty Clinic/Center
  • Anaconda, MT
  • NPI 1093397978
  NPD

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1902099716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PROFESSIONAL DR",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801332",
            "telephone_number": "252-747-8162",
            "fax_number": "252-747-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 BELVOIR HWY",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348193",
            "telephone_number": "252-695-6352",
            "fax_number": "252-695-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TRACEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME100735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-00205",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD15845",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN9975",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5922865",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia R. Richardson, ANP-C
• Kaitlin Richardson
• Maurice Devon Clay Richardson, M.D.
• Rebecca Churchill Richardson, PA-C
• Sarah Richardson, MS, CCC-SLP
• William James Richbourg, M.D.
• Tayla Monet Ricks, DNP, AGNP-C
• Leah Riddell
• Riding With the Hearts of Gold
• Rhonisha Ridley

• Family Medicine Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.