Individual provider Active NPI

Danyelle Paige Ridley, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Raeford, NC
National Provider Identifier
1184336893
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5017741 Issued in NC
Practice address
208 Triple Crown Dr
Raeford, NC 28376-7118
Phone
(910) 709-4393
NPI assigned
Dec 14, 2022
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 5017741 NC Primary

Addresses

Primary practice location

208 Triple Crown Dr
Raeford, NC 28376-7118

Mailing address

208 Triple Crown Dr
Raeford, NC 28376-7118
Phone (910) 709-4393

Other names 1

  • Danyelle Ridley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230313002400 OR Practitioner - Nurse Practitioner 0840664991 Reassigns benefits to 1 organization
I20230817003272 NC Practitioner - Nurse Practitioner 0840664991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert C Pennebaker PLLCGroup PAC ID 3870802010, 11 clinicians

Practice addresses (Care Compare)

2931 Breezewood Ave
Suite 104
Fayetteville, NC 28303-5281
Phone (910) 491-1134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017741NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert C. Pennebaker PLLC Psychiatric/Mental Health CurrentSince Jul 5, 2023 Accepting new patients
Mindful Therapy Group PC Psychiatric/Mental Health CurrentSince Mar 7, 2023 Accepting new patients
Ajels Psychiatric/Mental Health CurrentSince Jul 15, 2025 Accepting new patients
Ajels Psychiatric/Mental Health PastSince Mar 11, 2025 Accepting new patients

Locations

2931 Breezewood Ave
Ste 104
Fayetteville, NC 28303
Phone (910) 491-1134

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1184336893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 TRIPLE CROWN DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283767118",
            "telephone_number": "910-709-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 TRIPLE CROWN DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283767118",
            "telephone_number": "910-709-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "DANYELLE",
        "middle_name": "PAIGE",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5017741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANYELLE",
            "last_name": "RIDLEY",
            "credential": "PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.