RYAN OWEN BUNDREN LADAC II
NPI 1679168397
Counselor - Addiction (Substance Use Disorder) in Waynesboro, TN

Q: What is Ryan Bundren's NPI number?

The NPI number for Ryan Bundren is 1679168397. It was assigned to this individual provider in the NPPES registry on March 4, 2021.

Q: What is Ryan Bundren's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Bundren was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 04, 2021PECOS Enrolled

703 HURRICANE CREEK RD, WAYNESBORO, TN 38485(931) 279-6378 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 13, 2025, Mar 4, 2021 (2 updates tracked since 2021).

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About Ryan Owen Bundren Ladac Ii NPPES

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

RYAN OWEN BUNDREN LADAC II (NPI 1679168397) is an individual addiction (substance use disorder) provider in Waynesboro, Tennessee, licensed in Tennessee (1408) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679168397

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameRYAN OWEN BUNDRENCredential: LADAC II

Location Address703 HURRICANE CREEK RDWaynesboro, TN 38485-2226

Mailing Address703 Hurricane Creek RdWaynesboro, TN 38485-2226 · (931) 279-6378

Phone(931) 279-6378

Sole ProprietorYes

Enumeration DateMarch 4, 2021

Last NPPES UpdateJune 13, 20252 updates tracked since enumeration

NPPES CertifiedJune 13, 2025

✔ NPI 1679168397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in TN · 1408

703 HURRICANE CREEK RD, Waynesboro, TN 38485

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ryan Owen Bundren Ladac Ii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Ryan Bundren's NPI number?

The NPI number for Ryan Bundren is 1679168397. It was assigned to this individual provider in the NPPES registry on March 4, 2021.

Where is Ryan Bundren located?

Ryan Bundren practices at 703 Hurricane Creek Rd, Waynesboro, TN 38485. The listed phone number is (931) 279-6378.

What is Ryan Bundren's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Ryan Bundren enrolled in Medicare?

Yes. Ryan Bundren is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ryan Bundren was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.