Active NPI
Jon Calloway
- Addiction (Substance Use Disorder) Counselor
- Columbus, OH
National Provider Identifier
1629886437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.191001
- Practice address
- 6100 Channingway Blvd Ste 605
Columbus, OH 43232-2999 - Phone
- (614) 626-8464
- NPI assigned
- Dec 26, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.191001 | OH | Primary |
Addresses
Primary practice location
6100 Channingway Blvd Ste 605
Columbus, OH 43232-2999
Mailing address
4136 McAllister Ave
Columbus, OH 43227-1251
Phone (614) 735-7676
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.191001 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manifesting Excellence LLC | Current | Accepting new patients |
Locations
6100 Channingway Blvd
Ste 605
Columbus, OH 43232
Phone (614) 626-8464
Organizations & group practices 1
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": "1735171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1629886437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4136 MCALLISTER AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432271251",
"telephone_number": "614-735-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6100 CHANNINGWAY BLVD STE 605",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432322999",
"telephone_number": "614-626-8464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLOWAY",
"first_name": "JON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-26",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.191001",
"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 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.