Individual provider Active NPI

Ronald James Tyree, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1083389324
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
L8-0010261 Issued in DE
Practice address
410 Foulk Rd Ste 105
Wilmington, DE 19803-3835
Phone
(302) 478-6199
NPI assigned
Aug 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010261 DE Primary

Addresses

Primary practice location

410 Foulk Rd Ste 105
Wilmington, DE 19803-3835

Mailing address

44 E Stephen Dr
Newark, DE 19713-1862
Phone (302) 559-2693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20210825002264 DE Practitioner - Nurse Practitioner 3577968890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Sozo Wellness Centers of America LLCGroup PAC ID 6103210109, 2 clinicians

Practice addresses (Care Compare)

100 Biddle Ave
SPC 204
Newark, DE 19702-3983
Phone (302) 595-4924

200 S Dupont Blvd
Suite 104
Smyrna, DE 19977-1552
Phone (302) 559-2693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L8-0010261DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Torii Health and Wellness LLC CurrentSince Nov 1, 2024 Accepting new patients
Sozo Wellness Centers of America LLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

100 Biddle Ave
Spc 204
Newark, DE 19702
Phone (302) 595-4924

200 S DuPont Blvd
Ste 104
Smyrna, DE 19977
Phone (302) 363-5769

1 Harbison Way
Ste 222
Columbia, SC 29212

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1083389324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 E STEPHEN DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131862",
            "telephone_number": "302-559-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FOULK RD STE 105",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033835",
            "telephone_number": "302-478-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "RONALD",
        "middle_name": "JAMES",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.