Individual provider Active NPI

Louis D. Richmond, PHD

  • Psychologist
  • Verona, NJ
National Provider Identifier
1467549717
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SI02811 Issued in NJ
Practice address
450 Bloomfield Ave.
Suite 201
Verona, NJ 07044-2000
Phone
(973) 857-3113
Fax
(973) 857-0249
NPI assigned
Oct 6, 2006
Last updated
May 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X SI02811 NJ Primary

Addresses

Primary practice location

450 Bloomfield Ave.
Suite 201
Verona, NJ 07044-2000

Mailing address

450 Bloomfield Ave.
Suite 201
Verona, NJ 07044-2000
Phone (973) 857-3113

Other identifiers 4

IdentifierTypeStateIssuer
P2101539OtherOXFORD HEALTH
049945OtherVALUE OPTIONS
189022OtherMHN
4584902MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050602000690 NJ Practitioner - Clinical Psychologist 9537102322 Practice locations: Verona, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 Bloomfield Ave
Verona, NJ 07044-2000
Phone (973) 857-3113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SI02811NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1467549717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BLOOMFIELD AVE.",
            "address_2": "SUITE 201",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442000",
            "telephone_number": "973-857-3113",
            "fax_number": "973-857-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BLOOMFIELD AVE.",
            "address_2": "SUITE 201",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442000",
            "telephone_number": "973-857-3113",
            "fax_number": "973-857-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "LOUIS",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI02811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "P2101539",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "049945",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "189022",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4584902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

Verify at the official NPI Registry.