Richard Randall Ricketts, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

021580 Issued in GA

Practice address

1975 Century Blvd NE
Suite 6
Atlanta, GA 30345-3316

Phone

(404) 982-9938

Fax

(404) 982-9136

NPI assigned

Oct 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Atlanta Pediatric Surgery PC

  • Specialist
  • Atlanta, GA
  • NPI 1699951657
  NPD (past)
• Scottish Rite Children's Medical Center

  dba Children's Healthcare of Atlanta at Scottish Rite

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1184779332
  NPD (past)

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326131681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3287 ALTON RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414305",
            "telephone_number": "770-452-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 CENTURY BLVD NE",
            "address_2": "SUITE 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453316",
            "telephone_number": "404-982-9938",
            "fax_number": "404-982-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "RICHARD",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "021580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Rickenbaker
• Angela M Ricketts-Murray
• Diana Ricketts, RDN
• Janet M Ricketts, FNP
• John Carmichael Ricketts, M.D.
• Kathyrn Ricks
• Tamia Ricks
• Mary M Riddett, NP-C
• Amber Shontel Riddick, PSY.D.
• Ride Aid Transportation

• Pediatric Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.