Individual provider Active NPI

Ryan Rish

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1417721457
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW25444 Issued in FL
Practice address
836 Prudential Dr Ste 1507
Jacksonville, FL 32207-8342
Phone
(904) 376-3800
NPI assigned
Nov 9, 2023
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW25444 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1507
Jacksonville, FL 32207-8342

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260222000091 FL Practitioner - Clinical Social Worker 0941781538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1507
Jacksonville, FL 32207-8334
Phone (904) 376-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW25444FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC Mental Health CurrentSince Apr 1, 2026 Accepting new patients
Youth Crisis Center, Inc. PastSince Nov 12, 2023 Accepting new patients

Locations

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

836 Prudential Dr
Ste 1507
Jacksonville, FL 32207

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, 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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1417721457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1507",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078342",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISH",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.