Lester E Richardson, D.O.
Individual provider Active NPI Emergency Medicine Physician · Overland Park, KS
NPI 1942201678 · NPPES record last updated Jul 14, 2008
Key facts
- NPI
- 1942201678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 05-21420 (KS)
- Practice address
- 12300 Metcalf Ave
Overland Park, KS 66213-1324 - Phone
- (913) 317-7485
- NPI assigned
- Aug 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100630000743 | KS | Practitioner - Emergency Medicine | 9234195785 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-21420 | KS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Em Specialists PA | Emergency Medicine | Current |
Accepting new patients |
| Shawnee Mission Medical Center | Past | Accepting new patients | |
| ER Physicians South PA | Emergency Medicine | Past | Accepting new patients |
| Saint Luke'S South Hospital Inc. | Past | Accepting new patients |
Locations
1301 S Main St
Ottawa, KS 66067
Phone (785) 229-3367
9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 05-21420 | KS | Yes |
Addresses
Primary practice location
12300 Metcalf Ave
Overland Park, KS 66213-1324
Mailing address
PO Box 411039
Kansas City, MO 64141-1039
Phone (913) 234-1350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100231530C | Medicaid | KS | |
| 100231530A | Medicaid | KS | |
| 12598099 | Other | KS | BCBS OF KC MO |
| 246039101 | Medicaid | MO | |
| 01674018 | Other | BCBS KC MO GROUP 0167401 | |
| 12598119 | Other | MO | BCBS OF KC MO |
| 930036542 | Other | RR MEDICARE GROUP CG8899 | |
| P00215045 | Other | RR MEDICARE GROUP DC6712 |
Other providers in Overland Park, KS
- Richard L. Winburn, DDS P.a.
- Jillian Rachelle Richard
- Audrey Danielle Richards
- Stephanie Richards
- Jay L Richardson
- Skyler Richardson
- Walter P. Richardson
- Kathleen Gwen Richer
- Mollie Richert
- Celia Richey
All providers in Overland Park, KS · Emergency Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.