1780677724 NPI number — TADARRO L RICHARDSON MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780677724 NPI number — TADARRO L RICHARDSON MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RICHARDSON

Provider First Name:

TADARRO

Provider Middle Name:

L

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1780677724

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/12/2026

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

6101 BLUE LAGOON DR STE 200

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MIAMI

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

33126-3168

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

171 W LOWRY LN

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

LEXINGTON

Provider Business Practice Location Address State Name:

KY

Provider Business Practice Location Address Postal Code:

40503-3018

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

859-334-1550

Provider Business Practice Location Address Fax Number:

877-471-2996

Provider Enumeration Date:

08/24/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  20359 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 611012421C . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 64-203599 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: C68011 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 000000047826 . This is a "ANTHEM BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 61-1012421 . This is a "TPN CONTRACTS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 110031156 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 1404232 . This is a "UMWA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 0037678 . This is a "MEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 1284109 . This is a "UMWA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 611012421 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".