Ryan Owen Bundren, LADAC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1408 Issued in TN

Practice address

703 Hurricane Creek Rd
Waynesboro, TN 38485-2226

Phone

(931) 279-6378

NPI assigned

Mar 4, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/sperohealth/r4/

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.

• Spero Health of Tennessee, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Smyrna, TN
  • NPI 1538628904
  NPD

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1679168397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 HURRICANE CREEK RD",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852226",
            "telephone_number": "931-279-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 HURRICANE CREEK RD",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852226",
            "telephone_number": "931-279-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDREN",
        "first_name": "RYAN",
        "middle_name": "OWEN",
        "credential": "LADAC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Larae Boone, PHARM.D.
• Erin Lyn Brewer, B.A.
• Jacoby Brewer, PT, DPT
• Brian David Brison, PTA
• Buffalo River Services, Inc.
• Chelsea Leigh Butcher
• Macon Devaughn Carroll, PHARM.D.
• Shelia Gaye Carroll, COTA/L
• Angeline Agnes Casteel, C.PH.T
• Patricia D Castleman, FNP-C

• All providers in Waynesboro, TN
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.