Individual provider Active NPI

Jerry A. Riggs Sr., LMHC

  • Mental Health Counselor
  • Hollywood, FL
National Provider Identifier
1548917552
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH20787 Issued in FL
Practice address
4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755
Phone
(754) 209-1880
NPI assigned
Mar 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH20787 FL Primary

Addresses

Primary practice location

4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755

Mailing address

4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755
Phone (754) 209-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH20787FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Mar 13, 2022 Accepting new patients

Locations

4000 Hollywood Blvd
Ste 715S
Hollywood, FL 33021
Phone (754) 209-1880

Organizations & group practices 1

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1548917552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 715S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216755",
            "telephone_number": "754-209-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 715S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216755",
            "telephone_number": "754-209-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGGS",
        "first_name": "JERRY",
        "middle_name": "A.",
        "name_suffix": "Sr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.