Individual provider Active NPI

Jed Peren

  • General Practice Registered Nurse
  • Columbus, OH
National Provider Identifier
1053201061
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN.533869 Issued in OH
Practice address
815 W Broad St FL 2
Columbus, OH 43222-1464
Phone
(614) 717-0822
NPI assigned
Jul 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN.533869 OH Primary

Addresses

Primary practice location

815 W Broad St FL 2
Columbus, OH 43222-1464

Mailing address

815 W Broad St FL 2
Columbus, OH 43222-1464
Phone (614) 717-0822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN.533869OHMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Basecamp Recovery LLC CurrentSince Jul 13, 2025 Accepting new patients
Basecamp Recovery LLC CurrentSince Jul 13, 2025 Accepting new patients

Locations

815 W Broad St
Fl 2
Columbus, OH 43222
Phone (614) 717-0822

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1053201061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST FL 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221464",
            "telephone_number": "614-717-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST FL 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221464",
            "telephone_number": "614-717-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREN",
        "first_name": "JED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN.533869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.