Individual provider Active NPI

Demetria Athena Richards, APRN

  • Family Nurse Practitioner
  • Lebanon, TN
National Provider Identifier
1952032294
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31617 Issued in TN
Practice address
702 S Cumberland St
Lebanon, TN 37087-4110
Phone
(615) 444-2121
NPI assigned
Jun 17, 2022
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31617 TN Primary

Addresses

Primary practice location

702 S Cumberland St
Lebanon, TN 37087-4110

Mailing address

1150 Hawkins Crawford Rd
Cookeville, TN 38501-6661
Phone (931) 510-3759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20240405000134 TN Practitioner - Nurse Practitioner 7911345293 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31617TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anycare LLC CurrentSince Feb 25, 2024 Accepting new patients
Putnam Emergency Physicians, PLLC CurrentSince Mar 1, 2024 Accepting new patients
Staton Southern Medical, PLLC PastSince Jun 1, 2022 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

702 S Cumberland St
Lebanon, TN 37087
Phone (615) 444-2121

Organizations & group practices 3

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": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1952032294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 HAWKINS CRAWFORD RD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385016661",
            "telephone_number": "931-510-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S CUMBERLAND ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874110",
            "telephone_number": "615-444-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "DEMETRIA",
        "middle_name": "ATHENA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.