Runako Richardson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

291371 Issued in AZ

Practice address

3707 E Southern Ave Ste 1018
Mesa, AZ 85206-6201

Phone

(602) 878-7702

Fax

(602) 878-7702

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Runako Jadagu Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Southwest Behavioral Health Services IncGroup PAC ID 9739075854, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Lifeoak Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1164103594

  Multi-Specialty

  NPD Authorized official
• Southwest Behavioral Health Services

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1619982196
  NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD
• Brightstar Counseling PLLC

  • Psychiatry Physician
  • Harpers Woods, MI
  • NPI 1992819841
  NPD (past)
• St Health TX, P.a.

  • Clinical Psychologist
  • New York, NY
  • NPI 1982476685

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1992124622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 AIRPORT FWY STE 230",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE STE 1018",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066201",
            "telephone_number": "602-878-7702",
            "fax_number": "602-878-7702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Airport Fwy Ste 230",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "TX",
            "postal_code": "760216091",
            "country_code": "US",
            "telephone_number": "817-354-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "RUNAKO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "291371",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP125465",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "125465",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "125465",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP125465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUNAKO",
            "last_name": "JADAGU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Falice Richardson
• Jason Richardson
• Kelly Lynae Richardson, PA-C
• Nathan Richardson, CCC-SLP
• Rory M. Richardson, RPH
• Shauna Richardson
• Theresia Richardson
• Shilo Richins
• Deborah L Richter
• Madelynn Richtfort

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.