Michelle L Rickerby, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD09800 Issued in RI

Practice address

593 Eddy Street
Potter Basement
Providence, RI 02903-4923

Phone

(401) 444-8638

Fax

(401) 444-2085

NPI assigned

Jul 18, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1396763223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "POTTER 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4318",
            "fax_number": "401-444-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "POTTER BASEMENT",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8638",
            "fax_number": "401-444-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKERBY",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD09800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MR27488",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Shade Richardson, NP
• Brooke Richer, NP
• Jesse Richman, MD
• Michaele Richter, LICSW
• Elizabeth Rickard, PT
• Kenneth C. Rickler, MD
• Tania Rico, NP
• Mary Helen Riddle, NP
• Meghan Claye Riddle, M.D.
• Caitlin Rider

• Child & Adolescent Psychiatry Physician in Providence, RI
• Providers in Providence, RI by specialty
• Child & Adolescent Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.