Individual provider Active NPI

Renata Weatherspoon

  • Psychiatric/Mental Health Nurse Practitioner
  • Metairie, LA
National Provider Identifier
1134555790
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP07557 Issued in LA
Practice address
3350 Ridgelake Dr
Metairie, LA 70002-3836
Phone
(504) 517-3998
NPI assigned
Sep 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 101.0138671 VT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.015744 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP126296 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP07557 LA Primary

Addresses

Primary practice location

3350 Ridgelake Dr
Metairie, LA 70002-3836

Mailing address

3350 Ridgelake Dr
Metairie, LA 70002-3836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131125001178 LA Practitioner - Nurse Practitioner 0143456053 Practice locations: New Orleans, LA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

8516 Freret St
New Orleans, LA 70118-1160
Phone (504) 208-8600

8687 E Via de Ventura
Suite 310
Scottsdale, AZ 85258-3351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12.015744CTMDPsychiatric/Mental Health Nurse Practitioner
AP126296TXMDPsychiatric/Mental Health Nurse Practitioner
101.0138671VTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Feb 1, 2025 Accepting new patients
Advanced Practice Consulting LLC Psychiatric/Mental Health CurrentSince Jan 4, 2026 Accepting new patients
Icare Psychiatry & Consulting Corp Psychiatric/Mental Health PastSince Dec 6, 2020 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

814 SW Evangeline Trwy
Lafayette, LA 70501
Phone (337) 222-3707

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1379203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1134555790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 RIDGELAKE DR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 RIDGELAKE DR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023836",
            "telephone_number": "504-517-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSPOON",
        "first_name": "RENATA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-15",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0138671",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.015744",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP126296",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP07557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.