Individual provider Active NPI

Richard Fred Reckman, PH.D.

  • Psychologist
  • Cincinnati, OH
National Provider Identifier
1396838785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2775 Issued in OH
Practice address
4450 Carver Woods Dr
Cincinnati, OH 45242-5527
Phone
(513) 984-9940
Fax
(513) 984-9858
NPI assigned
Sep 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2775 OH Primary

Addresses

Primary practice location

4450 Carver Woods Dr
Cincinnati, OH 45242-5527

Mailing address

39 Walnut Ave
Cincinnati, OH 45215-4335
Phone (513) 821-8421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090425000008 OH Practitioner - Clinical Psychologist 3870641103 Practice locations: Cincinnati, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4450 Carver Woods Dr
Blue Ash, OH 45242-5527

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2775OHMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396838785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALNUT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452154335",
            "telephone_number": "513-821-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 CARVER WOODS DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452425527",
            "telephone_number": "513-984-9940",
            "fax_number": "513-984-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECKMAN",
        "first_name": "RICHARD",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.