Individual provider · Type 1 NPI

Dakota Richerson, PA-C

Physician Assistant · Bloomington, IN

NPI number 1639960073 Active

Practice location

1520 S Liberty Dr
Bloomington, IN 47403-5167

Call (812) 676-4500 Map

Mailing address

1456 Rogers Rd
West Frankfort, IL 62896-5452

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X10004895A (IN)
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1639960073

Dakota Richerson, PA-C's National Provider Identifier is 1639960073, issued on May 15, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Bloomington, IN. The record was last updated on Nov 26, 2025.