Charles David Richardson II, D.O.

Primary specialty

Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X

License

24662 Issued in MS

Practice address

2117 Broadway Drive
Hattiesburg, MS 39402-3210

Phone

(601) 288-8050

Fax

(601) 288-8058

NPI assigned

Jun 30, 2013

Last updated

Feb 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forrest County General Hospital

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
  • NPI 1295837631
  Medicare reassignment Care Compare group NPD
• Forrest County General Hospital

  dba Highland Center for Women's Health RHC

  • Rural Health Clinic/Center
  • Picayune, MS
  • NPI 1043820426
  NPD
• Forrest County General Hospital

  dba South Mississippi Psychiatric Group

  • Psychiatry Physician
  • Hattiesburg, MS
  • NPI 1275710212
  NPD

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1942640388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 BROADWAY DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023210",
            "telephone_number": "601-288-8050",
            "fax_number": "601-288-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 BROADWAY DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023210",
            "telephone_number": "601-288-8050",
            "fax_number": "601-288-8058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Merit Health Medical Group-Sr Behavioral Health",
            "address_2": "5001 Hardy Street",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021331",
            "country_code": "US",
            "telephone_number": "601-268-8029",
            "fax_number": "601-268-8394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-30",
        "last_updated": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "MS",
            "license": "24662",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "24662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "24662",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Avery Rhodes, DO
• Amanda Rochelle Rice, M.D.
• Amy Ricedorf, NCC
• Brenton G Richardson, MD
• Charles David Richardson, M.D.
• Cole McKee Richardson, DO
• Chastity E Richey, LMSW
• Heather L Richie, M.D.
• Ashli Richmond, NP
• Tera Riddick

• Neurodevelopmental Disabilities Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Neurodevelopmental Disabilities Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.