Individual provider Active NPI

Jerema E Holliday, MA

  • Adult Development & Aging Psychologist
  • Columbus, OH
National Provider Identifier
1114409513
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Practice address
5969 E Livingston Ave Ste 100
Columbus, OH 43232-2907
Phone
(614) 864-2700
Fax
(614) 864-2702
NPI assigned
Aug 31, 2018
Last updated
Aug 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X NU Primary
Group Psychotherapy Psychologist 103TP2701X NU

Addresses

Primary practice location

5969 E Livingston Ave Ste 100
Columbus, OH 43232-2907

Mailing address

1100 Brandywine Blvd Ste E3
Zanesville, OH 43701-1138
Phone (614) 864-2700

Other practice location 1

301 Main St Ste Jkl
Zanesville, OH 43701-3456
Phone (740) 297-7800

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Hermona Robinson Tru-Rob Counseling and Consulting PastSince May 1, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1114409513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BRANDYWINE BLVD STE E3",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011138",
            "telephone_number": "614-864-2700",
            "fax_number": "614-864-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5969 E LIVINGSTON AVE STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432322907",
            "telephone_number": "614-864-2700",
            "fax_number": "614-864-2702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Main St Ste Jkl",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437013456",
            "country_code": "US",
            "telephone_number": "740-297-7800",
            "fax_number": "740-297-7228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "JEREMA",
        "middle_name": "E",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 31, 2018; 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.