Individual provider Active NPI

Geri Richardson, M.D.

  • Psychiatry Physician
  • South Padre Island, TX
National Provider Identifier
1487855870
Registry record updated Aug 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H8352 Issued in TX
Practice address
4405 Padre Blvd
South Padre Island, TX 78597-7324
Phone
(972) 689-1800
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 65303 GA
Psychiatry Physician 2084P0800X H8352 TX Primary

Addresses

Primary practice location

4405 Padre Blvd
South Padre Island, TX 78597-7324

Mailing address

6223 Woodland Dr
Dallas, TX 75225-2838
Phone (972) 689-1800

Other practice location 1

6223 Woodland Dr
Dallas, TX 75225-2838
Phone (972) 689-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110502000381 GA Practitioner - Psychiatry 5597940874 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65303GAMDPsychiatry Physician
H8352TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Psychology Center, LLC Psychiatry CurrentSince Dec 25, 2016 Accepting new patients
Premier Healthcare Investments CurrentSince Nov 1, 2016 Accepting new patients
View Point Health CurrentSince Nov 14, 2014 Accepting new patients
Premier Healthcare Investments CurrentSince Nov 1, 2016 Accepting new patients

Locations

2900 Chamblee Tucker Rd
Bldg 16
Chamblee, GA 30341
Phone (770) 939-1288

175 Gwinnett Dr
Lawrenceville, GA 30046
Phone (678) 209-2394

509 Sumter St
Montezuma, GA 31063
Phone (478) 472-2321

Organizations & group practices 4

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1487855870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 WOODLAND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752252838",
            "telephone_number": "972-689-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 PADRE BLVD",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "785977324",
            "telephone_number": "972-689-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6223 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752252838",
            "country_code": "US",
            "telephone_number": "972-689-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "GERI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2024-08-11",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "65303",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H8352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Padre Island, TX

Sources for this page

Verify at the official NPI Registry.