Individual provider Active NPI

Joseph Holodnak

  • Speech-Language Pathologist
  • Hudson, OH
National Provider Identifier
1205557659
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.12029 Issued in OH
Practice address
1414 Carriage Hill Dr
Hudson, OH 44236-4049
Phone
(440) 897-2484
NPI assigned
Sep 5, 2022
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.12029 OH Primary

Addresses

Primary practice location

1414 Carriage Hill Dr
Hudson, OH 44236-4049

Mailing address

1414 Carriage Hill Dr
Hudson, OH 44236-4049
Phone (440) 897-2484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209001849 OH Practitioner - Qualified Speech Language Pathologist 8022487206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1275 Barlow Rd
Hudson, OH 44236-3709
Phone (234) 284-8478

171 N Cleveland Massillon Rd
Akron, OH 44333-2422
Phone (234) 466-0160

3522 Commercial Dr
Fairlawn, OH 44333-5106
Phone (234) 466-7788

4303 Trueman Blvd
Hilliard, OH 43026-2631
Phone (614) 319-3305

528 Rothrock Rd
Copley, OH 44321-3132
Phone (330) 576-3496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP.12029OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Oct 10, 2022 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Oct 10, 2022 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

Organizations & group practices 2

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1205557659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CARRIAGE HILL DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364049",
            "telephone_number": "440-897-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CARRIAGE HILL DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364049",
            "telephone_number": "440-897-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLODNAK",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.