Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104504794 Individual Practitioner Male Practitioner

Jacob Israel Ryder , LPC

Counselor - Professional • Hampton, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jacob Ryder, LPC is a registered healthcare professional specializing in Counselor - Professional in Hampton, VA. Practice services are available at 200 MEDICAL DR under active NPI credentials.

Jacob Ryder is affiliated with Hampton Newport News Community Services Board and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

200 Medical Dr

Hampton, VA 236661763

Telephone 7577880200
Associated Practice Facility / Clinic
🏢 Genoa Pharmacy Facility NPI 1497286124

Medicare Profile & Education

Medical School

Other

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Hampton, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.3 Yrs
State Avg: 14.7 Yrs
Regional Practice Density
137 Specialists

Practicing in Hampton, VA (6609 Statewide)

Telehealth Adoption Rate
7.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-07-05
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License VA 0701012308

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License VA 0710103463

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Csac
0710103463 (VA)
Commercial Insurance / Payer ID License
0701012308 (VA)

Hospital & Practice Group Affiliations

Hampton Newport News Community Services Board

200 Medical Dr A, Hampton, VA 236661763

Phone: 7577880200

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

20 Associated Practitioners
Dr. Joselito Morales , MD

Psychiatry & Neurology - Psychiatry

NPI 1043223845

Doctor of Medicine (M.D.)

Dr. Mukesh Shah , MD

Psychiatry & Neurology - Psychiatry

NPI 1093828451

Doctor of Medicine (M.D.)

Elisabeth Bauswell , LPC

Counselor - Professional

NPI 1184090300

Licensed Professional Counselor

Dr. Pierre Golpira , MD

Psychiatry & Neurology - Psychiatry

NPI 1205808912

Doctor of Medicine (M.D.)

Dr. Robert Marietta , MD

Psychiatry & Neurology - Psychiatry

NPI 1316080906

Doctor of Medicine (M.D.)

Maryann Hart , LPC, LMFT

Counselor - Professional

NPI 1346253085

Licensed Professional Counselor, Licensed Marriage and Family Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 05, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location July 05, 2023

Registered at 200 MEDICAL DR, HAMPTON, VA 236661763 (Tel: 7577880200)

📍
Updated Business Mailing Address July 05, 2023

Registered at 300 MEDICAL DR, HAMPTON, VA 236661765 (Tel: 7577880300)

👤
Provider Name / Credentials Updated July 05, 2023

Recorded as JACOB RYDER, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2023

Counselor (License #0701012308 in VA)

🟢
Initial NPI Registration & Enumeration July 05, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104504794
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 05, 2023
Last Update: July 05, 2023
Sole Proprietor: No

Mailing Address

300 Medical Dr

Hampton, VA 236661765

Phone: 7577880300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.