Organization Active NPI

Radnor Psychiatric Group

  • Psychiatry Physician
  • Brentwood, TN
National Provider Identifier
1437262854
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
18782 Issued in TN
Legal business name
RADNOR PSYCHIATRIC GROUP
Practice address
5123 Virginia Way
Suite C-11
Brentwood, TN 37027-7519
Phone
(615) 373-5205
Fax
(615) 373-5165
NPI assigned
Aug 17, 2006
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Dr. Richard Earle Rochester, MDNPI 1902802523
Title
Owner
Phone
(615) 373-5205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 18782 TN Primary

Addresses

Primary practice location

5123 Virginia Way
Suite C-11
Brentwood, TN 37027-7519

Mailing address

5123 Virginia Way
Suite C-11
Brentwood, TN 37027-7519
Phone (615) 373-5205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070604000628 TN Part B Supplier - Clinic/Group Practice 6406954114 Receives reassigned benefits from 1 practitioner
Practice locations: Brentwood, TN

National Provider Directory

National Provider Directory

Locations

5123 Virginia Way
Ste C11
Brentwood, TN 37027
Phone (615) 373-5205

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1437262854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 VIRGINIA WAY",
            "address_2": "SUITE C-11",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277519",
            "telephone_number": "615-373-5205",
            "fax_number": "615-373-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 VIRGINIA WAY",
            "address_2": "SUITE C-11",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277519",
            "telephone_number": "615-373-5205",
            "fax_number": "615-373-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADNOR PSYCHIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "ROCHESTER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EARLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-373-5205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "18782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.