RIDGEWOOD CLINICS PA
NPI 1023233749
Counselor - Mental Health in Jackson, MS
About Ridgewood Clinics Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RIDGEWOOD CLINICS PA (NPI 1023233749) is a healthcare organization registered as a mental health in Jackson, Mississippi and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through July 28, 2028 and lists Krishan K. Gupta, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ridgewood Clinics Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Ridgewood Clinics PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 25D2071185
Ridgewood Clinics · Jackson, MSFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ridgewood Clinics PA's NPI number?
The NPI number for Ridgewood Clinics PA is 1023233749. It was assigned to this organization in the NPPES registry on April 16, 2007.
Where is Ridgewood Clinics PA located?
Ridgewood Clinics PA is located at 1059 Ridgewood Clinic, Jackson, MS 39211. The listed phone number is (601) 957-3211.
What is Ridgewood Clinics PA's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Ridgewood Clinics PA enrolled in Medicare?
Yes. Ridgewood Clinics PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ridgewood Clinics PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Ridgewood Clinics PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Clinical Social Worker (2) and Psychiatry (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Ridgewood Clinics PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2071185) is associated with this NPI, valid through July 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Ridgewood Clinics PA accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Ridgewood Clinics PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ridgewood Clinics PA was last updated on August 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ridgewood Clinics Pa · NPI 1023233749
Mental Health organization in Jackson, Mississippi. Organization record, active in the CMS NPPES registry since April 16, 2007.
## Identity
- **NPI:** 1023233749 (Entity type: Organization)
- **Enumerated:** April 16, 2007
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Krishan Gupta, PHYSICIAN
## Practice location
- **Address:** 1059 RIDGEWOOD CLINIC, Jackson, MS 39211
- **Phone:** (601) 957-3211 · **Fax:** (601) 957-9753
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Clinical Social Worker (2), Psychiatry (1); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 27, 2014
- **Other identifiers:** Medicaid 09013996 (MS); Medicare ID-Type Unspecified C02024 (MS)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1023233749) · Data from the CMS NPPES public registry.