Individual provider Active NPI

Richelle Ashley Jefferson, MD

  • Family Medicine Physician
  • Mobile, AL
National Provider Identifier
1114488350
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.43046 Issued in AL
Practice address
2419 Gordon Smith Dr
Mobile, AL 36617-2318
Phone
(251) 434-3475
NPI assigned
Mar 29, 2019
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X MD.43046 AL Primary

Addresses

Primary practice location

2419 Gordon Smith Dr
Mobile, AL 36617-2318

Mailing address

PO Box 21595
Belfast, ME 04915-4112
Phone (251) 300-5941

Other practice location 1

1601 Center St Ste 2N
Mobile, AL 36604-1541
Phone (251) 434-3475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230224000106 AL Practitioner - Family Practice 2062845597 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altapointe Health Systems IncGroup PAC ID 1052224052, 97 clinicians

Practice addresses (Care Compare)

2419 Gordon Smith Dr
Mobile, AL 36617-2318
Phone (251) 461-3491

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.43046ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altapointe Health Systems, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Altapointe Health Systems, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Franklin Primary Health Center, Inc Family Medicine CurrentSince Nov 10, 2022 Accepting new patients
University of South Alabama Health Care Authority CurrentSince Aug 1, 2023 Accepting new patients
Altapointe Health Systems, Inc. Family Medicine Current Accepting new patients
Franklin Primary Health Center Inc. Family Medicine CurrentSince Nov 10, 2022 Accepting new patients
University of South Alabama Past Accepting new patients

Locations

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

1601 Center St
Mobile, AL 36604
Phone (251) 410-5437

1601 Center St
Ste 2N
Mobile, AL 36604
Phone (251) 434-3475

2400 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 305-4660

2419 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 434-3475

2423 Schillinger Rd S
Mobile, AL 36695
Phone (251) 660-5950

2451 University Hospital Dr
Rm 714
Mobile, AL 36617
Phone (251) 445-8282

5750A Southland Dr
Mobile, AL 36693
Phone (251) 450-5901

6701 Airport Blvd
#A1
Mobile, AL 36608
Phone (251) 633-8880

Interoperability endpoints

  • Direct secure messaging: richelle.jefferson.md.1@27270.direct.athenahealth.com
  • Direct secure messaging: rjefferson591966@direct.ochin.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1114488350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21595",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154112",
            "telephone_number": "251-300-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 GORDON SMITH DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172318",
            "telephone_number": "251-434-3475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Center St Ste 2N",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366041541",
            "country_code": "US",
            "telephone_number": "251-434-3475",
            "fax_number": "251-434-3837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "RICHELLE",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.43046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.