Individual provider Active NPI

Celine Richard, M.D. PHD

  • Pediatric Otolaryngology Physician
  • Memphis, TN
National Provider Identifier
1750909404
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
57.248750 Issued in OH
Practice address
51 N Dunlap St # G10
Memphis, TN 38105-4625
Phone
(901) 287-7337
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 65584 TN
Pediatric Otolaryngology Physician 207YP0228X 57.248750 OH Primary

Addresses

Primary practice location

51 N Dunlap St # G10
Memphis, TN 38105-4625

Mailing address

Pediatric ENT Department, Nationwide Children'S Hospita
700 Children'S Dr.
Columbus, OH 43205
Phone (614) 737-5744

Other practice location 1

Pediatric ENT Department, Nationwide Children's Hospita
700 Children's Dr.
Columbus, OH 43205
Phone (614) 737-5744

Other practice location 2

262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20221007000188 TN Practitioner - Pediatric MedicinePractitioner - Otolaryngology 8628454030 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.248750OHMDPediatric Otolaryngology Physician
65584TNMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Children'S Research Hospital, Inc. CurrentSince Feb 13, 2023 Accepting new patients

Locations

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

Interoperability endpoints

  • Direct secure messaging: crichard52674@stjude.direct-ci.com
  • Direct secure messaging: crichard24576@mlh.direct-ci.com

Organizations & group practices 2

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": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1750909404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEDIATRIC ENT DEPARTMENT, NATIONWIDE CHILDREN'S HOSPITA",
            "address_2": "700 CHILDREN'S DR.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43205",
            "telephone_number": "614-737-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST # G10",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Pediatric ENT Department, Nationwide Children's Hospita",
            "address_2": "700 Children's Dr.",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43205",
            "country_code": "US",
            "telephone_number": "614-737-5744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "262 Danny Thomas Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381053678",
            "country_code": "US",
            "telephone_number": "901-595-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "CELINE",
        "name_prefix": "Mrs.",
        "credential": "M.D. PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TN",
            "license": "65584",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OH",
            "license": "57.248750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.