DR. DEREK KEITH RICHARDSON (NPI# 1245247006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245247006 |
| Entity Type | Individual |
| Full Name | DR. DEREK KEITH RICHARDSON |
| Credential | M.D. |
| Practice Address |
200 Crescent Centre Parkway Kaiser Permanente Crescent Centre Medical Center Tucker GA 30084 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7704963609 |
| Mailing Telephone | 4043647070 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-12-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
054273 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215194790 | Derek W Richardson | Physical Therapy Assistant | 302 Hancock St, Holdrege, NE 68949-2741 | 2008-05-21 |
| 1871750851 | Derek Kuhl Richardson | Emergency Medicine | 1689 Turk St, San Francisco, CA 94115-4527 | 2008-05-19 |
| 1568552719 | Derek Proctor Richardson | Dermatology | Four Irongate Center, Glens Falls, NY 12801 | 2006-10-16 |
| 1477809697 | Derek Alexander Richardson | Optometrist | 10000 Bay Pines Blvd, Bay Pines, FL 33744 | 2012-07-25 |
| 1205061553 | Derek M Richardson | Family Medicine | 315 W 2nd St, Greenville, NC 27834-1969 | 2009-05-15 |
| Street Address |
200 CRESCENT CENTRE PARKWAY KAISER PERMANENTE CRESCENT CENTRE MEDICAL CENTER |
| City | TUCKER |
| State | GA |
| Zip Code | 30084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649403882 | Nida Usmani | Psychiatry & Neurology | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2009-09-03 |
| 1457519019 | Marion Ellen Howard | Internal Medicine | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2008-05-29 |
| 1629262407 | Robyn Q Daniell | Family Medicine | 200 Crescent Centre Parkway, Crescent Medical Centter Dpt of Adult Medicine, Tucker, GA 30084-7047 | 2007-09-05 |
| 1407047210 | Sandra Joy Mcfarland | Social Worker | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2007-08-06 |
| 1720278658 | Teresa Carol Whitehurst | Psychologist | 200 Crescent Centre Parkway, Kp Crescent Centre Medical Center, Tucker, GA 30084 | 2007-07-26 |
| 1386738987 | Shaanta A. Hanagud | Family Medicine | 200 Crescent Centre Parkway, Tucker, GA 30084 | 2006-10-03 |
| 1912009952 | Jane M Kerner-mendoza | Clinical Nurse Specialist | 200 Crescent Centre Parkway, Department of Behavioral Health, Tucker, GA 33084 | 2006-09-01 |
| 1083725295 | Stanley John Jagielski | Obstetrics & Gynecology | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2006-08-31 |
| 1053422261 | James W Hamilton | Psychologist | 200 Crescent Centre Parkway, Department of Behavioral Health, Tucker, GA 30084 | 2006-08-31 |
| 1023020781 | Lori C. Levey | Social Worker | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2006-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740449537 | Yasmeen S Fareeduddin | Psychiatry & Neurology | 200 Crescent Center Parkway, Kaiser Permanente Crescent Medical Center, Tucker, GA 30084 | 2008-06-05 |
| 1093938276 | Keisha Brown | Psychiatry & Neurology | 4426 Hugh Howell Rd, Ste. B-332, Tucker, GA 30084-4918 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205468840 | Angela Leigh Eubanks | Psychiatry & Neurology | 11 S Winston St, Reynolds, GA 31076-3200 | 2020-02-11 |
| 1265064364 | Haven Psychiatry, LLC | Psychiatry & Neurology | 5871 Glenridge Dr Ste 220, Atlanta, GA 30328-5305 | 2020-02-06 |
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1093249393 | Healing for All LLC | Psychiatry & Neurology | 3307 Sir Henry St, East Point, GA 30344-5831 | 2017-04-13 |
| 1699216416 | Abva, Inc | Psychiatry & Neurology | 4565 Rockmart Rd Se, Unit 1261, Silver Creek, GA 30173-2442 | 2017-03-13 |
| 1225436017 | Aatma Seva Health Inc | Psychiatry & Neurology | 523 Dixie St Ste 3, Carrollton, GA 30117-3870 | 2014-12-11 |
| 1619309309 | Howel William Slaughter Jr. | Psychiatry & Neurology | 40 Abington Ct Nw, Atlanta, GA 30327-1352 | 2013-08-05 |
| 1427493568 | Susan Kirsch | Psychiatry & Neurology | 7000 Peachtree Dunwoody Rd Bldg 16, Atlanta, GA 30328-1655 | 2013-05-02 |
| 1023362852 | Rivertown Psychiatry, PC | Psychiatry & Neurology | 1520 22nd Street, Columbus, GA 31901-1632 | 2012-10-31 |
| 1548550429 | Bene' Mental Wellness | Psychiatry & Neurology | 1835 Savoy Dr Ste 101, Atlanta, GA 30341-1073 | 2011-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.