NPIMap

Individual provider Active NPI

Derrick L Richardson, MD

  • Gastroenterology Physician
  • Fort Smith, AR
National Provider Identifier
1992727150
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C-8460 Issued in AR
Practice address
6801 Rogers Ave
Fort Smith, AR 72903-4067
Phone
(479) 274-3200
Fax
(479) 274-3289
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C-8460 AR Primary

Addresses

Primary practice location

6801 Rogers Ave
Fort Smith, AR 72903-4067

Mailing address

PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000

Other identifiers 2

IdentifierTypeStateIssuer
129829001MedicaidAR
010063815OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000638 AR Practitioner - Gastroenterology 3971643594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Arkansas College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

6801 Rogers Ave
Fort Smith, AR 72903-4067
Phone (479) 274-4100

Hospital & facility affiliations

  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Mercy Hospital Ozark Hospital, Ozark, AR, CCN 041303
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Mercy Hospital Booneville Hospital, Booneville, AR, CCN 041318

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy263
Upper gastrointestinal (GI) endoscopy for acid reflux321

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 16, 2017 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 16, 2017 Accepting new patients
Mercy Hospital Paris PastSince Jul 1, 2019 Accepting new patients
Mercy Hospital Booneville PastSince Jul 1, 2019 Accepting new patients
Mercy Hospital Fort Smith Past Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

6801 Rogers Ave
Fl 2
Fort Smith, AR 72903
Phone (479) 274-2800

7001 Rogers Ave
Fort Smith, AR 72903
Phone (479) 478-3510

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

Interoperability endpoints

  • Direct secure messaging: drichardson133902@directc.mercy.net

Organizations & group practices 5

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 5

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1992727150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-3200",
            "fax_number": "479-274-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DERRICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "C-8460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129829001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "010063815",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.