Active NPI
Ryan Thomas Eisert, LSW, CDCA
- Social Worker
- Columbus, OH
National Provider Identifier
1306339288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2208553
- Practice address
- 825 Dennison Ave
Columbus, OH 43215-1315 - Phone
- (614) 291-4691
- NPI assigned
- Jun 14, 2018
- Reactivated
- Dec 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.167018 | OH | |
| Social Worker | 104100000X | S.2208553 | OH | Primary |
Addresses
Primary practice location
825 Dennison Ave
Columbus, OH 43215-1315
Mailing address
825 Dennison Ave
Columbus, OH 43215-1315
Phone (614) 291-4691
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.167018 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2208553 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1306339288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 DENNISON AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151315",
"telephone_number": "614-291-4691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 DENNISON AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151315",
"telephone_number": "614-291-4691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISERT",
"first_name": "RYAN",
"middle_name": "THOMAS",
"credential": "LSW, CDCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"deactivation_date": "2022-11-29",
"reactivation_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.167018",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2208553",
"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 Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.