Individual provider Active NPI

Stephen Guess Richardson, MD

  • Family Medicine Physician
  • San Marcos, TX
National Provider Identifier
1992020440
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P3805 Issued in TX
Practice address
401 Broadway St Ste a
San Marcos, TX 78666-7771
Phone
(512) 805-5650
Fax
(512) 392-4744
NPI assigned
Mar 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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 P3805 TX Primary

Addresses

Primary practice location

401 Broadway St Ste a
San Marcos, TX 78666-7771

Mailing address

401 Broadway St Ste a
San Marcos, TX 78666-7771
Phone (512) 805-5650

Other identifiers 3

IdentifierTypeStateIssuer
P01390909OtherRR MEDICARE
339722601MedicaidTX
36089YMG2OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140909001961 TX Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 7214156009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in Shreveport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

401 Broadway St
Suite a
San Marcos, TX 78666-7771
Phone (512) 805-5650

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 1, 2021 Accepting new patients

Locations

1340 Wonder World Dr
Ste 4301
San Marcos, TX 78666
Phone (512) 353-6400

401 Broadway St
Ste A
San Marcos, TX 78666
Phone (512) 393-5520

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: srichardson254540@christushealth.direct-ci.net

Organizations & group practices 2

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 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": "1269648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1992020440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BROADWAY ST STE A",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667771",
            "telephone_number": "512-805-5650",
            "fax_number": "512-392-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BROADWAY ST STE A",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667771",
            "telephone_number": "512-805-5650",
            "fax_number": "512-392-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "STEPHEN",
        "middle_name": "GUESS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-27",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P3805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01390909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339722601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "36089YMG2",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.