Active NPI
Richard Cull Christensen, MD
- Psychiatry Physician
- Jacksonville, FL
National Provider Identifier
1114987666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME62682
- Practice address
- 611 E Adams St
Jacksonville, FL 32202-2847 - Phone
- (904) 394-8068
- Fax
- (904) 353-7345
- NPI assigned
- Mar 27, 2006
- 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 | ME62682 | FL | Primary |
Addresses
Primary practice location
611 E Adams St
Jacksonville, FL 32202-2847
Mailing address
611 E Adams St
Jacksonville, FL 32202-2847
Phone (904) 394-8068
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000648227B | Medicaid | GA | |
| 260042608 | Other | FL | RAILROAD MEDICARE |
| 3764508-00 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME62682 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Past | Accepting new patients | |
| Florida Clinical Practice Association Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Durable Medical Equipment & Medical Supplies
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- NPI 1609529478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1114987666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 E ADAMS ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322022847",
"telephone_number": "904-394-8068",
"fax_number": "904-353-7345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 E ADAMS ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322022847",
"telephone_number": "904-394-8068",
"fax_number": "904-353-7345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTENSEN",
"first_name": "RICHARD",
"middle_name": "CULL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME62682",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000648227B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "260042608",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3764508-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.