Ryan Federmeyer, B.S., CADC II, QMHA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19-QMHA-I-01933 Issued in OR

Practice address

91150 N Coburg Industrial Way
Coburg, OR 97408-9512

Phone

(541) 687-1110

NPI assigned

Nov 21, 2017

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

• Ryan Viens Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 15, 2022.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1922512359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91150 N COBURG INDUSTRIAL WAY",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "974089512",
            "telephone_number": "541-687-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91150 N COBURG INDUSTRIAL WAY",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "974089512",
            "telephone_number": "541-687-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERMEYER",
        "first_name": "RYAN",
        "credential": "B.S., CADC II, QMHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "19-07-08",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "19-QMHA-I-01933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "VIENS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Miguel Estevez, M.D., PH.D.
• Kari Evans
• April Lynn Evernden
• Sarah Farmer, LMT
• Suzan Marie Farr
• John Michael Ford, QMHA, CADC1
• Layne R. Frambes
• Daschel Franz, M.S.
• Kristine Lee Freeze, CADC I
• Jillian Joan Fuller

• All providers in Coburg, OR
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.