Nicholas Ryan Medici

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2315335I Issued in CA

Practice address

44319 11TH St E
Lancaster, CA 93535-3855

Phone

(661) 942-1026

NPI assigned

Jul 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Design for Change

  • Substance Abuse Rehabilitation Facility
  • Lancaster, CA
  • NPI 1003435629
  NPD
• Design for Change

  • Substance Abuse Rehabilitation Facility
  • Lancaster, CA
  • NPI 1447709019
  NPD (past)

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1033896972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 E AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935353870",
            "telephone_number": "661-942-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44319 11TH ST E",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935353855",
            "telephone_number": "661-942-1026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1066 E Avenue J",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935353870",
            "country_code": "US",
            "telephone_number": "661-942-1026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44501 16th St W Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935342884",
            "country_code": "US",
            "telephone_number": "661-942-1026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDICI",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "2315335I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mediscan
• Medport Restorative Care & Rehab Supplies, Inc.
• Kimberly Medrano Puga

• Addiction (Substance Use Disorder) Counselor in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.