Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dakota Richerson, PA-C

Individual provider Physician Assistant · NPI 1639960073

Dakota Richerson, PA-C is a Physician Assistant in Bloomington, Indiana. Qualified in 2025, 1 year ago. Practices with Iu Health Medical Group, LLC, a 4,351-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Licensed in
IN
In the registry since
2025
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone: (812) 676-4500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 10004895A (IN)

Record details

NPI number1639960073
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 15, 2025
Last updated in NPPESNovember 26, 2025
Certification dateNovember 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Iu Health Medical Group, Llc — 4351 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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