Active NPI
Richard P. Fitzgibbons, M.D.
- Psychiatry Physician
- West Conshohocken, PA
National Provider Identifier
1710175658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- PA011908E
- Practice address
- 1001 Conshohocken State Rd
Suite 312
West Conshohocken, PA 19428-2970 - Phone
- (610) 397-0950
- Fax
- (610) 397-0954
- NPI assigned
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | PA011908E | PA | Primary |
Addresses
Primary practice location
1001 Conshohocken State Rd
Suite 312
West Conshohocken, PA 19428-2970
Mailing address
100 Four Falls Center
Suite 312
W. Conshohocken, PA 19428-2950
Phone (610) 397-0950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 22, 2016 through Jul 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA011908E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1710175658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 FOUR FALLS CENTER",
"address_2": "SUITE 312",
"city": "W. CONSHOHOCKEN",
"state": "PA",
"postal_code": "194282950",
"telephone_number": "610-397-0950",
"fax_number": "610-397-0954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 CONSHOHOCKEN STATE RD",
"address_2": "SUITE 312",
"city": "WEST CONSHOHOCKEN",
"state": "PA",
"postal_code": "194282970",
"telephone_number": "610-397-0950",
"fax_number": "610-397-0954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGIBBONS",
"first_name": "RICHARD",
"middle_name": "P.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-04",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "PA011908E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Conshohocken, PA
- Big Smiles Pennsylvania, PC
- Sandra Cochran, CRNP
- Davita Medical Group Philadelphia, LLC
- Davita Medical Group Philadelphia, LLC
- Dermone Dermatology Associates of the Keystone State, P.C
- Suzette Plauschinat Groarke, RPH.
- Emmanuel Michael Mahlis, MD
- Toni Ann McMillen, NP
- Charles E Meidt, MD
- Joann M Murray-Schluckebier, CRNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.