Active NPI
Donald W Ridenour
- Mental Health Counselor
- Kokomo, IN
National Provider Identifier
1902301807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39002823A
- Practice address
- 1520 W Mulberry St
Kokomo, IN 46901-4272 - Phone
- (765) 438-9445
- NPI assigned
- Mar 24, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39002823A | IN | Primary |
Addresses
Primary practice location
1520 W Mulberry St
Kokomo, IN 46901-4272
Mailing address
1520 W Mulberry St
Kokomo, IN 46901-4272
Phone (765) 438-9445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39002823A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mending Minds, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/24167/brand/1/csg/1/fhir/r4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521849600000",
"number": "1902301807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 W MULBERRY ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469014272",
"telephone_number": "765-438-9445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 W MULBERRY ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469014272",
"telephone_number": "765-438-9445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDENOUR",
"first_name": "DONALD",
"middle_name": "W",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-24",
"last_updated": "2018-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39002823A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.