Holy Family Prenatal Care, LLC

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

Legal business name

HOLY FAMILY PRENATAL CARE, LLC

Practice address

359 Forest Ave Ste 202
Dayton, OH 45405-4559

Phone

(937) 228-4492

Fax

(937) 228-4495

NPI assigned

Mar 12, 2007

Organization subpart

Yes

Parent organization

ELIZABETH'S NEW LIFE CENTER INCAs reported in NPPES

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

Authorized official

Name

Mrs. Vivian Koob

Title

Executive Director

Phone

(937) 226-7414

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Elizabeth'S New Life Center

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Elizabeth'S New Life Center

  • Voluntary or Charitable Agency
  • Dayton, OH
  • NPI 1477769446
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann T Moell, MD

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1457378978
  Medicare reassignment NPD
• Elizabeth R Cirillo, CNM

  • Advanced Practice Midwife
  • Cincinnati, OH
  • NPI 1679227300
  NPD (past)
• Syrah Elizabeth Nicaisse, CNM

  • Midwife
  • Wright Patterson Air Force Base, OH
  • NPI 1245530641
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1023140274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 FOREST AVE STE 202",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054559",
            "telephone_number": "937-228-4492",
            "fax_number": "937-228-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 FOREST AVE STE 202",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054559",
            "telephone_number": "937-228-4492",
            "fax_number": "937-228-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY FAMILY PRENATAL CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELIZABETH'S NEW LIFE CENTER INC",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "KOOB",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-226-7414",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2414284",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Holthaus, FNP-BC
• Julia Ann Holthaus, LPN
• Connor Holton
• Robert Michael Holtrup, PA-C
• Holy Family Pediatrics
• Brittanie Holzfaster, MSW, LISW-S
• Brent Anthony Homan, R.PH.
• Garret Homan, NURSE PRACTITIONER
• Home Care Assistance of Dayton
• Home Care Doctors, Inc

• Obstetrics Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Obstetrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.