Jonathan Ridenour, PA
NPI 1699233403 · Psychologist · Tyler, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jonathan Ridenour, PA is a Psychologist organization in Tyler, TX (NPI 1699233403).
Provider details
- NPI number
- 1699233403
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Michelle Bice, Office Manager(903) 630-5788
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-03-11
- Last updated
- 2023-09-18
- Certified
- 2023-09-18
Frequently asked questions
- What is Jonathan Ridenour, PA's NPI number?
- Jonathan Ridenour, PA's National Provider Identifier (NPI) is 1699233403, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jonathan Ridenour, PA?
- Jonathan Ridenour, PA is classified in the NPPES registry as Psychologist (Behavioral Health & Social Service Providers).
- Where is Jonathan Ridenour, PA located?
- Jonathan Ridenour, PA's practice location on file with NPPES is 4801 Troup Hwy Ste 502, Tyler, TX 75703-2357.
- What is Jonathan Ridenour, PA's phone number?
- The practice phone number listed in the NPPES registry for Jonathan Ridenour, PA is (972) 424-9212.
- Does Jonathan Ridenour, PA accept Medicare?
- Jonathan Ridenour, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Jonathan Ridenour, PA?
- The authorized official listed on Jonathan Ridenour, PA's NPPES record is Michelle Bice, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jonathan Ridenour, PA's NPI active?
- Yes — Jonathan Ridenour, PA's NPI (1699233403) is active in the NPPES registry as of the last update on 2023-09-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.