Individual provider Active NPI

Kendall Baker Ryno, LCSW

  • Clinical Social Worker
  • Broomfield, CO
National Provider Identifier
1285484147
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09931666 Issued in CO
Practice address
12303 Airport Way Ste 125
Broomfield, CO 80021-2729
Phone
(970) 310-3406
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LSW.000925074 CO
Clinical Social Worker 1041C0700X CSW.09931666 CO Primary

Addresses

Primary practice location

12303 Airport Way Ste 125
Broomfield, CO 80021-2729

Mailing address

12303 Airport Way Ste 125
Broomfield, CO 80021-2729
Phone (970) 310-3406

Other practice location 1

250 Fillmore St Unit 150
Denver, CO 80206-5001
Phone (844) 843-7279

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331004686 CO Practitioner - Clinical Social Worker 3678058229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 W Oak St
FL 4
Fort Collins, CO 80521-2734

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

PO Box
Dallas, TX 75284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW.000925074COMDSocial Worker
CSW.09931666COMDClinical Social Worker

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1285484147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 AIRPORT WAY STE 125",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212729",
            "telephone_number": "970-310-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 AIRPORT WAY STE 125",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212729",
            "telephone_number": "970-310-3406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Fillmore St Unit 150",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802065001",
            "country_code": "US",
            "telephone_number": "844-843-7279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYNO",
        "first_name": "KENDALL",
        "middle_name": "BAKER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.000925074",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09931666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.