Active NPI
Keith R Holan, MD
- Gastroenterology Physician
- Cuyahoga Falls, OH
National Provider Identifier
1174562599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35043324H
- Practice address
- 3033 State Rd
Cuyahoga Falls, OH 44223-3614 - Phone
- (330) 945-4739
- Fax
- (330) 945-7381
- NPI assigned
- Jun 5, 2006
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 35043324H | OH | Primary |
Addresses
Primary practice location
3033 State Rd
Cuyahoga Falls, OH 44223-3614
Mailing address
PO Box 609
Cuyahoga Falls, OH 44222-0609
Phone (330) 923-6606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0419210 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1174562599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 609",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442220609",
"telephone_number": "330-923-6606",
"fax_number": "330-923-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 STATE RD",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442233614",
"telephone_number": "330-945-4739",
"fax_number": "330-945-7381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLAN",
"first_name": "KEITH",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "35043324H",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0419210",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.