Individual provider Active NPI

Christy Jolene Richmond, NURSE PRACTITIONER

  • Nurse Practitioner
  • Lake Havasu City, AZ
National Provider Identifier
1952186207
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
237287 Issued in AZ
Practice address
1990 McCulloch Blvd N Ste 109a
Lake Havasu City, AZ 86403-5749
Phone
(928) 208-1481
Fax
(928) 505-6474
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 237287 AZ Primary
Acute Care Nurse Practitioner 363LA2100X 237287 AZ

Addresses

Primary practice location

1990 McCulloch Blvd N Ste 109a
Lake Havasu City, AZ 86403-5749

Mailing address

1990 McCulloch Blvd N Ste 109a
Lake Havasu City, AZ 86403-5749
Phone (928) 208-1481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230928003042 AZ Practitioner - Nurse Practitioner 9032563713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indigo Healthcare LLCGroup PAC ID 6305260829, 5 clinicians

Practice addresses (Care Compare)

1990 McCulloch Blvd N
Suite 109
Lake Havasu City, AZ 86403-5749
Phone (888) 253-6598

Hospital & facility affiliations

  • River Valley Home Health Home health agency, Lake Havasu, AZ, CCN 037402

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237287AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indigo Healthcare LLC CurrentSince May 22, 2025 Accepting new patients

Locations

1990 McCulloch Blvd N
Ste 109
Lake Havasu City, AZ 86403
Phone (928) 505-6473

1916 N 700 W
Ste 110
Layton, UT 84041
Phone (801) 444-0221

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1952186207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD N STE 109A",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035749",
            "telephone_number": "928-208-1481",
            "fax_number": "928-505-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD N STE 109A",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035749",
            "telephone_number": "928-208-1481",
            "fax_number": "928-505-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "CHRISTY",
        "middle_name": "JOLENE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "237287",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "237287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.