FRED RICHARDSON JR. (NPI# 1194702092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194702092 |
| Entity Type | Individual |
| Full Name | FRED RICHARDSON JR. |
| Credential | M.D. |
| Practice Address |
904 Medical Park Dr Suite 3 Effingham IL 62401-2193 |
| Practice Telephone | 2175402350 |
| Practice Fax Number | 2173472323 |
| Mailing Telephone | 2175402350 |
| Mailing Fax Number | 2173472323 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2016-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036078174 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036078174 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801974928 | Fred Richardson | Psychologist | 17809 Harvest Ave, Cerritos, CA 90703-5545 | 2006-11-02 |
| 1356482442 | Fred Richardson | Counselor | 105 Prescott Park, Concord, NH 03302 | 2007-02-09 |
| Street Address |
904 MEDICAL PARK DR SUITE 3 |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-2193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801499 | David J Bitzer | Urology | 904 Medical Park Dr, Effingham, IL 62401-2193 | 2005-09-13 |
| 1467813022 | Shelby Renea Overbeck | Registered Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2016-03-10 |
| 1598005993 | Ronna R Hurren | Registered Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2013-02-21 |
| 1275873689 | Connie L Coatney | Licensed Practical Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2013-02-21 |
| 1508060252 | Cathy Raddatz | Registered Nurse | 904 Medical Park Dr, Ste 2, Effingham, IL 62401-2193 | 2007-06-14 |
| 1699893735 | Sarah Bush Lincoln Health Center | Otolaryngology | 904 Medical Park Dr, Effingham, IL 62401-2193 | 2007-03-27 |
| 1912917188 | Ruben D Boyajian | Surgery | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2006-08-09 |
| 1245290782 | Dva Renal Healthcare Inc | Clinic/Center | 904 Medical Park Dr, Suite 1, Effingham, IL 62401-2193 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568021269 | Rhodes To Health, LLC | Chiropractor | 200 E. Fayette Ave, Effingham, IL 62401 | 2019-06-07 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013198712 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 502 W Virginia Ave, Effingham, IL 62401-2260 | 2007-11-21 |
| 1407816044 | Sean F. Flynn | Family Medicine | 512 N Maple St, Effingham, IL 62401-2005 | 2006-03-27 |
| 1922067289 | Mid-illinois Medical Care Associates, LLC | Family Medicine | 1207 Network Centre Dr, Suite 3, Effingham, IL 62401-4632 | 2006-03-23 |
| 1942208087 | Paul D. Oltman | Family Medicine | 905 N Maple St, Effingham, IL 62401-6433 | 2005-07-12 |
| 1710489349 | Adrienne Beth Kinney | Family Medicine | 503 N Maple St, Effingham, IL 62401 | 2018-02-28 |
| 1952747388 | James Richard Gartner | Family Medicine | 3 Woodland Dr, Effingham, IL 62401 | 2013-05-13 |
| 1083922090 | Paul D. Oltman, M.d., S.c. | Family Medicine | 900 W Temple Ave, Suite 204, Effingham, IL 62401-2121 | 2010-09-24 |
| 1578743688 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 900 W Temple Ave, Suite 103, Effingham, IL 62401-2121 | 2007-11-06 |
| 1013931567 | Andrew Robert Gage | Family Medicine | 512 N Maple St, Effingham, IL 62401-2005 | 2006-07-27 |
| 1376578492 | Hope E Knauer | Family Medicine | 300 N Maple St, Effingham, IL 62401-2003 | 2006-07-11 |
| Find all providers in EFFINGHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.