Healthcare Provider Details

I. General information

NPI: 1386360055
Provider Name (Legal Business Name): PEYTON R OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 E BROAD ST
COLUMBUS OH
43205-1156
US

IV. Provider business mailing address

899 E BROAD ST
COLUMBUS OH
43205-1156
US

V. Phone/Fax

Practice location:
  • Phone: 614-655-3345
  • Fax: 614-317-4689
Mailing address:
  • Phone: 614-655-3345
  • Fax: 614-317-4689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2410607
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: