Individual provider Active NPI

Heather L Richie, M.D.

  • Internal Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1699779371
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22801 Issued in MS
Practice address
1101 S 28TH Ave Ste a
Hattiesburg, MS 39402-2610
Phone
(601) 261-1640
Fax
(601) 579-5240
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 110760 MO
Hospitalist Physician 208M00000X 22801 MS
Internal Medicine Physician 207R00000X 22801 MS Primary

Addresses

Primary practice location

1101 S 28TH Ave Ste a
Hattiesburg, MS 39402-2610

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 288-4329

Other identifiers 2

IdentifierTypeStateIssuer
204649800MedicaidMO
05279741MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hrichie35873@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131115000407 MS Practitioner - Internal MedicinePractitioner - Hospitalist 0345222899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

  • Forrest General Home Care Home health agency, Hattiesburg, MS, CCN 257127
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110760MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Sep 1, 2013 Accepting new patients
Hattiesburg Clinic PA CurrentSince Sep 1, 2013 Accepting new patients
Liberty Medicine Specialists, Inc. Internal Medicine PastSince Jun 1, 2006 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1101 S 28th Ave
Ste D
Hattiesburg, MS 39402
Phone (601) 296-2980

1101 S 28th Ave
#A
Hattiesburg, MS 39402
Phone (601) 261-1640

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1699779371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-288-4329",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S 28TH AVE STE A",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022610",
            "telephone_number": "601-261-1640",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHIE",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "110760",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "22801",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204649800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05279741",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hrichie35873@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1101 S 28th Ave Ste A",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394022610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.