Individual provider Active NPI

Ronald Nydam

  • Professional Counselor
  • Denver, CO
National Provider Identifier
1205659273
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0000364 Issued in CO
Practice address
9185 E Kenyon Ave Ste 120
Denver, CO 80237-1856
Phone
(303) 741-5588
Fax
(303) 741-9977
NPI assigned
Nov 6, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0000364 CO Primary

Addresses

Primary practice location

9185 E Kenyon Ave Ste 120
Denver, CO 80237-1856

Mailing address

480 S Marion Pkwy Apt 1603a
Denver, CO 80209-2559
Phone (616) 822-1536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0000364COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pastoral Counseling for Denver, Inc. PastSince Oct 1, 1999 Accepting new patients

Organizations & group practices 1

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": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1205659273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 S MARION PKWY APT 1603A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802092559",
            "telephone_number": "616-822-1536",
            "fax_number": "303-741-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9185 E KENYON AVE STE 120",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371856",
            "telephone_number": "303-741-5588",
            "fax_number": "303-741-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYDAM",
        "first_name": "RONALD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0000364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.