Jeremiah Richardson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

11035 NE Sandy Blvd
Portland, OR 97220

Phone

(503) 258-4200

NPI assigned

Dec 18, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barbara Majors LLCGroup PAC ID 6608139498, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Barbara Majors LLC

  • Adult Mental Health Clinic/Center
  • Milwaukie, OR
  • NPI 1104323245
  Medicare reassignment Care Compare group NPD
• Morrison Child and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1346382975
  NPD (past)

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1588062806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301911",
            "telephone_number": "503-258-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11035 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-258-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11035 NE Sandy Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972202553",
            "country_code": "US",
            "telephone_number": "503-258-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JEREMIAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keaton Richardson-Ray, PT, DPT, ATC, CSCS
• Bruce Levoyle Richardson, DMD01/28/1950
• Cynthia Richardson, CADCI
• Heather Breanne Richardson
• Jeannette J Richardson, R.N.
• Joan Richardson, PA-C
• Kara Anu Richardson, MD
• Kelsey Linde Richardson
• Kevin Richardson
• Mackenzie Richardson, PMHNP-BC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.