Healthcare Provider Details

I. General information

NPI: 1245186014
Provider Name (Legal Business Name): RICHARD RYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 S CENTRAL AVE
COLUMBUS OH
43223-1301
US

IV. Provider business mailing address

180 BREHL AVE
COLUMBUS OH
43222-1313
US

V. Phone/Fax

Practice location:
  • Phone: 614-274-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613562
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: