Individual provider Active NPI

Paul Larson Richard, DO

  • Family Medicine Physician
  • Montgomery, AL
National Provider Identifier
1952810558
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO.2152 Issued in AL
Practice address
4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975
Phone
(334) 613-3680
Fax
(334) 613-3685
NPI assigned
Sep 26, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO.2152 AL Primary

Addresses

Primary practice location

4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975

Mailing address

4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975
Phone (334) 613-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200804003544 AL Practitioner - Family Practice 1052736204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Alabama College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Alabama Physicians, LLPGroup PAC ID 0143379388, 12 clinicians

Practice addresses (Care Compare)

400 N Edwards St
Enterprise, AL 36330-2510
Phone (334) 347-0584

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Alabama Physicians, LLP Current Accepting new patients
Northern Alabama Physicians, LLP CurrentSince Jun 27, 2020 Accepting new patients
QHG of Enterprise Inc Past Accepting new patients
QHG of Enterprise Inc Past Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952810558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD STE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162975",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD STE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162975",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "PAUL",
        "middle_name": "LARSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.2152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.