{"npi":"1750366175","type":"NPI-1","status":"active","name":{"display":"Bethany Richerson Mpt","other":[],"first":"BETHANY","last":"RICHERSON","middle":"D","credential":"MPT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":false,"state":"IN","license":"05007579A"},{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"KY","license":"004243"}]},"addresses":[{"purpose":"LOCATION","street_1":"165 NATCHEZ TRACE AVE","city":"BOWLING GREEN","state":"KY","postal_code":"421037940","country_code":"US","street_2":"STE 200","phone":"2707964698","fax":"2707823274"},{"purpose":"MAILING","street_1":"165 NATCHEZ TRACE AVE","city":"BOWLING GREEN","state":"KY","postal_code":"421037940","country_code":"US","street_2":"STE 200","phone":"2707964698","fax":"2707823274"}],"license":{"state":"KY","number":"004243"},"identifiers":[{"type_code":"01","label":"Other","value":"000000590928","state":"KY","issuer":"BLUE CROSS BLUE SHIELD"},{"type_code":"01","label":"Other","value":"000000280266","state":"IN","issuer":"BLUE CROSS BLUE SHIELD"},{"type_code":"05","label":"Medicaid","value":"200839570","state":"IN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20081208000379","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"KY","pac_id":"5395722409"}]},"enumeration_date":"2005-12-08","last_updated":"2013-07-02","_meta":{"source":"NPPES","snapshot_date":"2013-07-02","doc_url":"https://findmynpi.com/api"}}