Individual provider Active NPI

Ryan Joseph Williams, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor, CO
National Provider Identifier
1134874456
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0997353 Issued in CO
Practice address
1300 Main St
Windsor, CO 80550-5989
Phone
(970) 686-5646
NPI assigned
Feb 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 0997353 CO Primary

Addresses

Primary practice location

1300 Main St
Windsor, CO 80550-5989

Mailing address

1300 Main St
Windsor, CO 80550-5989
Phone (970) 686-5646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220627002317 CO Practitioner - Nurse Practitioner 5496134173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Health Physicians Colorado LLCGroup PAC ID 8921273038, 278 clinicians

Practice addresses (Care Compare)

1300 Main St
Windsor, CO 80550-5989
Phone (970) 686-5646

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

2001 70TH Ave
Suite 200
Greeley, CO 80634-4613
Phone (970) 810-3550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0997353COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC Current Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2022 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1300 Main St
Windsor, CO 80550
Phone (970) 686-5645

Organizations & group practices 3

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1134874456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-686-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-686-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0997353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

Verify at the official NPI Registry.