Individual provider Active NPI

Mary Alice Richter

  • Obstetrics & Gynecology Physician
  • New Orleans, LA
National Provider Identifier
1225458847
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
081849 Issued in GA
Practice address
1430 Tulane Ave
SL-11
New Orleans, LA 70112-2632
Phone
(704) 582-3595
NPI assigned
Apr 22, 2014
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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
Obstetrics & Gynecology Physician 207V00000X 081849 GA Primary

Addresses

Primary practice location

1430 Tulane Ave
SL-11
New Orleans, LA 70112-2632

Mailing address

3495 Piedmont Rd NE
Attn: Tobie Shelley
Atlanta, GA 30305-1717
Phone (404) 365-0966

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190304002201 GA Practitioner - Obstetrics/Gynecology 2163705591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Warren Alpert Medical School of Brown University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081849GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Obstetrics & Gynecology CurrentSince Dec 3, 2018 Accepting new patients
Dekalb Medical Psych Unit Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3645

2470 Mount Zion Pkwy
Bldg 200
Jonesboro, GA 30236
Phone (770) 527-9031

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1225458847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "ATTN: TOBIE SHELLEY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-365-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "SL-11",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "704-582-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "MARY ALICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "081849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.