Ethan Christian Richard, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2019-01089 Issued in NC

Practice address

885 Gold Hill Rd Ste 506
Fort Mill, SC 29708-7946

Phone

(804) 869-0341

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc Urgent Care and Family Care of WNC PLLCGroup PAC ID 2567713332, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, 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.

• Afc Urgent Care and Family Care of WNC, PLLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1679066658
  Medicare reassignment Care Compare group NPD
• Matrix Occupational Health P.C.

  • Urgent Care Clinic/Center
  • Fayetteville, NC
  • NPI 1144279670
  Medicare reassignment NPD
• Primary Care Plus of Leawood LLC

  • Sports Medicine (Family Medicine) Physician
  • Leawood, KS
  • NPI 1225336597
  NPD (past) Authorized official
• Primary Care Plus, LLC

  • Family Medicine Physician
  • Lees Summit, MO
  • NPI 1205140712
  NPD (past) Authorized official
• Sports Med Plus of Leawood LLC

  • Sports Medicine (Family Medicine) Physician
  • Leawood, KS
  • NPI 1467750232
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1962439109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10840 VALLEY HILL RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077452",
            "telephone_number": "913-291-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 GOLD HILL RD STE 506",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087946",
            "telephone_number": "804-869-0341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3680 Robinwood Rd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "28054",
            "country_code": "US",
            "telephone_number": "888-381-4858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "ETHAN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "82176",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006025644",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2006025644",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA1297008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Reynolds, RBT
• Nathan Reynolds, LMT
• Norka Reynolds
• Kendrah Rhoden, RBT
• Riccobene & Associates CCC, DDS, PC
• Kelly L Richard, LCSW, LISW-CP
• Rachel Richman, PHARMD
• Emily Riggs, M.S. CCC-SLP
• Corey Leighton Riley, LPC
• Teresa Ann Rimmer, MA, CCC-SLP

• Family Medicine Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.