Richard Bergeron II, PMHNP, MSN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Houma, LA
NPI 1700323540 · NPPES record last updated Jun 17, 2022
Key facts
- NPI
- 1700323540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- AP09162 (LA)
- Practice address
- 1014 W Tunnel Blvd
Houma, LA 70360-4050 - Phone
- (985) 851-1717
- Fax
- (985) 851-7183
- NPI assigned
- Jan 31, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Teche Action Board Inc
Practice addresses (Care Compare)
1014 W Tunnel Blvd
Houma, LA 70360-4050
Phone (985) 851-1717
1124 7TH St
Morgan City, LA 70380-1951
Phone (985) 384-2371
3528 Hwy 70 S
Pierre Part, LA 70339-4452
Phone (985) 252-6211
471 Central Ave
Reserve, LA 70084-5509
Phone (985) 479-1315
5642 W Main St
Houma, LA 70360-1250
Phone (985) 853-2273
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170509001945 | LA | Practitioner - Nurse Practitioner | 3971880584 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP09162 | LA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teche Action Board, Inc. | Current |
Accepting new patients | |
| Teche Action Board, Inc. | Current |
Accepting new patients | |
| Teche Action Board Inc | Current | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board Inc | Past | Accepting new patients |
Locations
18333 Highway 182
Rm 505
Baldwin, LA 70514
Phone (337) 924-9418
2555 Highway 18
Edgard, LA 70049
Phone (337) 828-2550
159 E 3rd St
Edgard, LA 70049
Phone (985) 497-8726
1115 Weber St
Franklin, LA 70538
Phone (337) 828-2550
827 N Pine St
Gramercy, LA 70052
Phone (225) 258-9490
1014 W Tunnel Blvd
Houma, LA 70360
Phone (985) 851-1717
189 Mozart Dr
Houma, LA 70363
Phone (985) 868-3700
5642 W Main St
Houma, LA 70360
Phone (985) 448-3737
393 Greenwood Dr
La Place, LA 70068
Phone (985) 359-6492
1124 7th St
Morgan City, LA 70380
Phone (985) 384-2371
3528 Highway 70 S
Pierre Part, LA 70339
Phone (985) 252-6211
1709 Ridgefield Rd
Thibodaux, LA 70301
Phone (985) 446-7341
22187 Highway 20
Vacherie, LA 70090
Phone (225) 258-4980
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP09162 | LA | Yes |
Addresses
Primary practice location
1014 W Tunnel Blvd
Houma, LA 70360-4050
Mailing address
1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2436546 | Medicaid | LA | |
| 570122 | Other | LA | MEDICARE |
Other providers in Houma, LA
- Emily Gilcrease Bergeron
- Gene Francis Bergeron
- Jason P Bergeron Sr.
- Megan Lindsey Bergeron
- Nicollette Bergeron
- Sarah Hays Bergeron
- Ted Patrick Bergeron
- Tori Nicole Bergeron
- Carolyn W Bernard
- Larry David Bernard
All providers in Houma, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.