Individual provider Active NPI

Payton Runyan

  • Social Worker
  • Baltimore, MD
National Provider Identifier
1104435502
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
29224 Issued in MD
Practice address
5820 York Rd Ste 202
Baltimore, MD 21212-3620
Phone
(301) 345-1022
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 29224 MD Primary

Addresses

Primary practice location

5820 York Rd Ste 202
Baltimore, MD 21212-3620

Mailing address

5820 York Rd Ste 202
Baltimore, MD 21212-3620
Phone (301) 345-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260211002067 MD Practitioner - Clinical Social Worker 7618456468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2805 Fait Ave
Baltimore, MD 21224-3837

9627 Philadelphia Rd
Suite 160
Rosedale, MD 21237-4154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29224MDMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
Directions for Youth & Families, Inc. PastSince Aug 1, 2020 Accepting new patients
Directions for Youth & Families, Inc PastSince Aug 1, 2020 Accepting new patients

Locations

1114 Benfield Blvd
Ste G
Millersville, MD 21108
Phone (410) 780-4320

9627 Philadelphia Rd
Ste 160
Rosedale, MD 21237
Phone (410) 780-5205

Organizations & group practices 4

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1104435502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 YORK RD STE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123620",
            "telephone_number": "301-345-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 YORK RD STE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123620",
            "telephone_number": "301-345-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "PAYTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "29224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.