Dr Baxter Key Richardson Iv, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Jackson, California. He went to University Of Iowa, Rj & L Carver College Of Medicine and graduated in 2012 and has 13 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Mother Lode Diagnostic Imaging Inc, Mother Lode Diagnostic Imaging Inc and his current practice location is
200 Mission Blvd, Jackson, California. You can reach out to his office (for appointments etc.) via phone at
(209) 223-7560.
Dr Baxter Key Richardson Iv is licensed to practice in California (license number A148942) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306109905.
Physician's Profile
| Full Name | Dr Baxter Key Richardson Iv |
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| Gender | Male |
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| Speciality | Diagnostic Radiology |
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| Experience | 13 Years |
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| Location | 200 Mission Blvd, Jackson, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Baxter Key Richardson Iv attended and graduated from University Of Iowa, Rj & L Carver College Of Medicine in 2012
NPI Data:
- NPI Number: 1306109905
- Provider Enumeration Date: 06/19/2012
- Last Update Date: 06/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 7911271168
- Enrollment ID: I20170926004362
Medical Identifiers
Medical identifiers for Dr Baxter Key Richardson Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306109905 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | R9512 (Iowa) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | A148942 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mother Lode Diagnostic Imaging Inc | 9739176892 | 16 |
| Mother Lode Diagnostic Imaging Inc | 9739176892 | 16 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Baxter Key Richardson Iv allows following entities to bill medicare on his behalf.
| Entity Name | Providence Medical Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285890624
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346 |
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| Entity Name | Mother Lode Diagnostic Imaging Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053456061
PECOS PAC ID: 9739176892
Enrollment ID: O20040623001281 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Baxter Key Richardson Iv is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Baxter Key Richardson Iv, MD
Po Box 5617,
Saginaw, MI 48603-0617
Ph: (209) 262-1845 | Dr Baxter Key Richardson Iv, MD
200 Mission Blvd,
Jackson, CA 95642-2564
Ph: (209) 223-7560 |
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