Individual provider Active NPI

Richard Wade Menefee III, CRNP

  • Gerontology Nurse Practitioner
  • Florence, AL
National Provider Identifier
1922848688
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1-130743 Issued in AL
Practice address
3479 County Road 94
Florence, AL 35634-4845
Phone
(256) 297-1799
NPI assigned
May 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-130743 AL
Gerontology Nurse Practitioner 363LG0600X 1-130743 AL Primary

Addresses

Primary practice location

3479 County Road 94
Florence, AL 35634-4845

Mailing address

206 Whitfield Dr
Athens, AL 35613-2718
Phone (256) 278-0569

Other practice location 1

206 Whitfield Dr
Athens, AL 35613-2718
Phone (256) 278-0569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002001305 AL Practitioner - Nurse Practitioner 3072044924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mission Behavioral Health LLCGroup PAC ID 8628485935, 5 clinicians

Practice addresses (Care Compare)

Florence, AL 35634
Phone (256) 740-9306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-130743ALMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern NP Associates, LLC CurrentSince Sep 9, 2024 Accepting new patients
Mission Behavioral Health, LLC CurrentSince Jul 18, 2024 Accepting new patients

Locations

611 W Market St
Athens, AL 35611
Phone (256) 232-1620

22969 Highway 25
Columbiana, AL 35051
Phone (205) 669-1712

5968 Wall Triana Hwy
Madison, AL 35757
Phone (256) 430-8417

931 Fairfax Park
Tuscaloosa, AL 35406
Phone (205) 343-7301

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1922848688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 WHITFIELD DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132718",
            "telephone_number": "256-278-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3479 COUNTY ROAD 94",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356344845",
            "telephone_number": "256-297-1799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Whitfield Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356132718",
            "country_code": "US",
            "telephone_number": "256-278-0569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENEFEE",
        "first_name": "RICHARD",
        "middle_name": "WADE",
        "name_suffix": "III",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-130743",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-130743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.