NPIMap

Organization Active NPI

Holzer Hospital Foundation

Doing business as Holzer Extra Care

  • In Home Supportive Care Agency
  • Gallipolis, OH
National Provider Identifier
1083216923
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HOLZER HOSPITAL FOUNDATION
Doing business as
Holzer Extra Care
Practice address
2881 State Route 160
Gallipolis, OH 45631-8441
Phone
(740) 441-3914
Fax
(740) 441-3917
NPI assigned
Nov 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Michael R. Canady
Title
Chief Executive Officer
Phone
(740) 446-5051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2881 State Route 160
Gallipolis, OH 45631-8441

Mailing address

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 441-3914

Other identifiers 1

IdentifierTypeStateIssuer
0170667MedicaidOH

Other names 1

  • Holzer Extra Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Holzer Medical Clinic7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1083216923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-441-3914",
            "fax_number": "740-441-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2881 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318441",
            "telephone_number": "740-441-3914",
            "fax_number": "740-441-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLZER HOSPITAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "CANADY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "740-446-5051"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170667",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holzer Extra Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.