JACOB ISRAEL RYDER LPC
NPI 1104504794
Counselor - Professional in Hampton, VA

Active since July 05, 2023PECOS EnrolledAccepts Medicare Assignment
200 MEDICAL DR, HAMPTON, VA 23666(757) 788-0200 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacob Israel Ryder Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB ISRAEL RYDER LPC (NPI 1104504794) is an individual professional provider in Hampton, Virginia, licensed in Virginia (0701012308) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS and is a graduate of Other.

NPPES Registry Identity

NPI1104504794
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJACOB ISRAEL RYDERCredential: LPC
Location Address200 MEDICAL DRHampton, VA 23666-1763
Mailing Address300 Medical DrHampton, VA 23666-1765 · (757) 788-0300
Sole ProprietorNo
Medical School CMSOther
Enumeration DateJuly 5, 2023
NPPES CertifiedJuly 5, 2023
NPI 1104504794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in VA · 0701012308
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0710103463 (VA)
200 MEDICAL DR, Hampton, VA 23666

Other Identifiers 2

Other0710103463VA · Csac
Other0701012308VA · License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacob Israel Ryder Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981142999
PECOS Enrollment IDI20240821000919
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR, SUITE A
HAMPTON, VA 23666
Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR
HAMPTON, VA 23666
Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR, SUITE A & B
HAMPTON, VA 23666
Counselor (Professional)
200 MEDICAL DR
HAMPTON, VA 23666
Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR, SUITE B
HAMPTON, VA 23666
Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR, SUITE A
HAMPTON, VA 23666
Counselor (Professional)
200 MEDICAL DR, SUITE A
HAMPTON, VA 23666
Psychiatry & Neurology (Psychiatry)
200 MEDICAL DR, SUITE A
HAMPTON, VA 23666

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Ryder's NPI number?

The NPI number for Jacob Ryder is 1104504794. It was assigned to this individual provider in the NPPES registry on July 5, 2023.

Where is Jacob Ryder located?

Jacob Ryder practices at 200 Medical Dr, Hampton, VA 23666. The listed phone number is (757) 788-0200.

What is Jacob Ryder's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jacob Ryder enrolled in Medicare?

Yes. Jacob Ryder is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacob Ryder was last updated on July 5, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.