JONATHAN RIDENOUR, PA (NPI# 1699233403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699233403 |
| Entity Type | Organization |
| Organization Name | JONATHAN RIDENOUR, PA |
| Practice Address |
4801 Troup Hwy Ste 502 Tyler TX 75703-2357 |
| Mailing Address |
Po Box 940165 Plano TX 75094-0165 |
| Practice Telephone | 9724249212 |
| Practice Fax Number | 9725091450 |
| Mailing Telephone | 9724249212 |
| Mailing Fax Number | 9725091450 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Authorized Official Name | STEPHANIE HELD (OFFICE MANAGER) |
| Authorized Official Telephone | 9724249212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
4801 TROUP HWY STE 502 |
| City | TYLER |
| State | TX |
| Zip Code | 75703-2357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932326840 | Robert Jerald Shore | Psychologist | 804 Spring Creek Dr, Tyler, TX 75703-3537 | 2007-04-20 |
| 1982716189 | Erick R. Lenert | Psychologist | 1121 E Southeast Loop 323, Ste. 204, Tyler, TX 75701-9660 | 2006-08-31 |
| 1659389617 | Thomas Wilson Renfroe Jr. | Psychologist | 2010 Sybil Ln, Tyler, TX 75703-1818 | 2006-08-04 |
| 1033127279 | Sandra Harper | Psychologist | 2010 Sybil Ln Ste 100, Tyler, TX 75703 | 2006-08-03 |
| 1609404912 | Trenesha Hill | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-03-31 |
| 1952935389 | Joseph Jacob Whitehouse | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-02-25 |
| 1598306581 | Ron L. Roberts, M.s., P.C. | Psychologist | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701-9660 | 2019-10-01 |
| 1578044384 | Sandra Harper Pllc | Psychologist | 2010 Sybil Ln Ste 100, Tyler, TX 75703-1817 | 2018-08-29 |
| 1477049252 | Sandy Harper PC | Psychologist | 2010 Sybil Ln Ste 100, Tyler, TX 75703-1817 | 2018-07-05 |
| 1821514001 | Stephanie Jernigan Simmons | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2017-08-18 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.