John David Richardson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

11411 Issued in MS

Practice address

439 N Jackson St Ste D
Brookhaven, MS 39601-2912

Phone

(601) 835-9499

Fax

(601) 833-7808

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Psychiatry

Education

Baylor College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.richardson.1@17762.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4

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.

• KDMC Physician Clinics LLC

  • Multi-Specialty Clinic/Center
  • Brookhaven, MS
  • NPI 1861739161
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1144230038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 N JACKSON ST STE D",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012912",
            "telephone_number": "601-835-9499",
            "fax_number": "601-833-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 N JACKSON ST STE D",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012912",
            "telephone_number": "601-835-9499",
            "fax_number": "601-833-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "11411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119784",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reinhard Clinic PLLC
• Elaine Ruth Reinhard, M.D.
• Reliable Oxygen
• Jennifer Remington, FNP-C
• Charles Asa Reynolds, M.D.
• Carole Rider
• Robert Watts Pharmacy
• James E Roberts, MD
• Elizabeth Danielle Robin, LPC
• Arniece Robinson

• Psychiatry Physician in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.