Active NPI
Richard Earl Rhoden, MD
- Psychiatry Physician
- Jackson, MS
National Provider Identifier
1073716387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 06460
- Practice address
- 4500 I-55 North
Suite 248
Jackson, MS 39211-5966 - Phone
- (601) 982-8330
- Fax
- (601) 982-8314
- NPI assigned
- Jun 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 06460 | MS | Primary |
Addresses
Primary practice location
4500 I-55 North
Suite 248
Jackson, MS 39211-5966
Mailing address
4500 I-55 North
Suite 248
Jackson, MS 39211-5966
Phone (601) 982-8330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0013854 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 15, 2012 through Nov 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073716387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 I-55 NORTH",
"address_2": "SUITE 248",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115966",
"telephone_number": "601-982-8330",
"fax_number": "601-982-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 I-55 NORTH",
"address_2": "SUITE 248",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115966",
"telephone_number": "601-982-8330",
"fax_number": "601-982-8314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODEN",
"first_name": "RICHARD",
"middle_name": "EARL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MS",
"license": "06460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0013854",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.