DR. KENNETH JOE RICHARDSON (MD) – Diagnostic Radiology Physician, NPI 1861477127

DR. KENNETH JOE RICHARDSON (MD) is a healthcare provider. based in Eden prairie, Minnesota. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 00019405 (AL). The NPI Number for DR. KENNETH JOE RICHARDSON (MD) is 1861477127

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH JOE RICHARDSON (MD)
NPI
1861477127
Phone
(952) 595-1100
Address
11995 Singletree Ln Ste 500
Enumeration Date
9 December 2005
Last Update Date
1 June 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
9525951100
Graduation Year
1989 (37 years ago)
PAC ID
8325946544
Group Practice PAC ID
4981608817
Professional Enrollment ID
I20040510001370
Address ID
AL352266001HO4737XCTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,801 DIAGNOSTIC RADIOLOGY in MN

Provider Addresses for DR. KENNETH JOE RICHARDSON (MD)

  • 11995 Singletree Ln Ste 500

    Eden Prairie, MN 553445349

    Phone: (952) 595-1100

    Fax: (612) 294-4903

    Type: Location

  • 1825, Park Place, Oak Park, Montgomery, Montgomery County, Alabama, 36106, United States

    MONTGOMERY, AL 361173439

    Phone: (334) 293-8747

    Fax: (334) 834-2185

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040510001370IDiagnostic RadiologyALTBD
I20230815003877IDiagnostic RadiologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view1,8691,506$0
70450Ct scan head or brain without contrast800754$0
71046X-ray of chest, 2 views386369$0
74176Ct scan of abdomen and pelvis without contrast340325$0
74177Ct scan of abdomen and pelvis with contrast327322$0
View full utilization report →

Insurance plans in this area (ZIP 55344)

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Provider's Procedures

DR. KENNETH JOE RICHARDSON (MD) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYAL74177CT scan of abdomen and pelvis with contrast9797

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981608817View full group profile
NameSpecialtyState
Diagnostic RadiologySC
-SC
-MN
-MN
Diagnostic RadiologyNY
-MN
Diagnostic RadiologyTN
Diagnostic RadiologyMN
Diagnostic RadiologyMN
Diagnostic Radiology, Nuclear MedicineCO

Reviews

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Frequently asked questions

How do I look up DR. KENNETH JOE RICHARDSON (MD) by NPI?
Use NPI 1861477127 when you need to reference DR. KENNETH JOE RICHARDSON (MD) in forms, claims, or directories.
Is DR. KENNETH JOE RICHARDSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. KENNETH JOE RICHARDSON (MD)'s specialty in plain language?
Clinically, the directory lists DR. KENNETH JOE RICHARDSON (MD) with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. KENNETH JOE RICHARDSON (MD)?
The page summarizes Eden Prairie, Minnesota for DR. KENNETH JOE RICHARDSON (MD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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