Individual provider Active NPI

Renee R. Richesin, M.D.

  • Psychiatry Physician
  • Vestavia Hills, AL
National Provider Identifier
1306062989
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
19202 Issued in AL
Practice address
1025 Montgomery Hwy Ste 200
Vestavia Hills, AL 35216-2830
Phone
(205) 637-3055
Fax
(205) 623-1686
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 19202 AL Primary

Addresses

Primary practice location

1025 Montgomery Hwy Ste 200
Vestavia Hills, AL 35216-2830

Mailing address

1025 Montgomery Hwy Ste 200
Vestavia Hills, AL 35216-2830
Phone (205) 637-3055

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
I20190212002552 AL Practitioner - PsychiatryPractitioner - Other (Physician)Practitioner - Internal Medicine 6507104825 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19202ALMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
Alabama Post-Acute Medical Service 1 PC CurrentSince Dec 18, 2018 Accepting new patients
NM Pacs 2 LLC CurrentSince Jan 1, 2022 Accepting new patients
Wellspring Christian Clinic, Inc. Past Accepting new patients

Locations

1555 Hillabee St
Alexander City, AL 35010
Phone (256) 329-0847

1020 Tuscaloosa Ave SW
Birmingham, AL 35211
Phone (205) 253-2738

280 Mt Hebron Rd
Elmore, AL 36025
Phone (334) 265-7585

3312 Woodley Rd
Montgomery, AL 36116
Phone (251) 867-6077

1720 Knowles Rd
Phenix City, AL 36869
Phone (334) 291-0485

857 Crawford Ln
Prichard, AL 36617
Phone (251) 433-9801

Organizations & group practices 4

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1306062989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MONTGOMERY HWY STE 200",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352162830",
            "telephone_number": "205-637-3055",
            "fax_number": "205-623-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MONTGOMERY HWY STE 200",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352162830",
            "telephone_number": "205-637-3055",
            "fax_number": "205-623-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHESIN",
        "first_name": "RENEE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "19202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia Hills, AL

Sources for this page

Verify at the official NPI Registry.