Individual provider Active NPI

Jerome Richard Jr., PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Plaquemine, LA
National Provider Identifier
1366253213
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
242512 Issued in LA
Practice address
23450 Eden St
Plaquemine, LA 70764-2528
Phone
(225) 614-2857
Fax
(225) 452-9079
NPI assigned
Jan 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN141212 LA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 242512 LA Primary

Addresses

Primary practice location

23450 Eden St
Plaquemine, LA 70764-2528

Mailing address

4540 Foret St
Addis, LA 70710-2553

Other practice location 1

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

Other names 1

  • Jerome Richard Other name

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
I20251016002577 LA Practitioner - Nurse Practitioner 9830686419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

23450 Eden St
Plaquemine, LA 70764-2528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN141212LAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Mental Health Psychiatric/Mental Health CurrentSince Sep 15, 2025 Accepting new patients

Locations

23450 Eden St
Plaquemine, LA 70764
Phone (225) 614-2857

Organizations & group practices 1

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": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1366253213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 FORET ST",
            "city": "ADDIS",
            "state": "LA",
            "postal_code": "707102553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23450 EDEN ST",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707642528",
            "telephone_number": "225-614-2857",
            "fax_number": "225-452-9079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2390 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705064205",
            "country_code": "US",
            "telephone_number": "337-261-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "JEROME",
        "name_suffix": "Jr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "LA",
            "license": "RN141212",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "242512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEROME",
            "last_name": "RICHARD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Plaquemine, LA

Sources for this page

Verify at the official NPI Registry.