NPIMap

Organization Active NPI

Holzer Hospital Foundation

  • Home Health Agency
  • Point Pleasant, WV
National Provider Identifier
1255768552
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
APPLIED Issued in WV
Legal business name
HOLZER HOSPITAL FOUNDATION
Practice address
2605 Jackson Ave
Point Pleasant, WV 25550-1615
Phone
(304) 675-6380
Fax
(304) 675-6882
NPI assigned
Oct 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Rodney Stout, MD
Title
Ceo
Phone
(740) 446-5051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X APPLIED WV Primary

Addresses

Primary practice location

2605 Jackson Ave
Point Pleasant, WV 25550-1615

Mailing address

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140307001048 WV Part A Provider - Home Health Agency 6901896927 Practice locations: Point Pleasant, WV

Home health agency certification: CCN 517140

Legal name
HOLZER HOSPITAL FOUNDATION
Doing business as
HOLZER HOME CARE, MASON COUNTY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 27, 2015
Last certification
Nov 5, 2020
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Aug 3, 1929 in OH
Enrollment address
2605 Jackson Ave
Point Pleasant, WV 25550-1615

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Holzer Home Care, Mason CountyCCN 517140
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Jan 27, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Occupational therapy

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

2413 Jackson Ave
Unit 1
Point Pleasant, WV 25550

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gerald Roach Individual Corporate DirectorChairman of the Board Jan 1, 2024
Paul Reed Individual Corporate DirectorBoard Member Feb 12, 2014
Robert Wade Pugh Individual Corporate DirectorBoard Member Jan 1, 2017
Robert Massie Individual W-2 Managing EmployeeAd; Aug 5, 2024
Lori Harrison Individual W-2 Managing EmployeeCedentialing Coordinator May 11, 2018
Shana R Booher Individual Corporate DirectorDirector of Credentialing Jan 1, 2020
Brent Saunders Individual Corporate DirectorBoard Member Jan 1, 2024
Brad Munn Individual Corporate DirectorBoard Member Oct 17, 2007
Craig Alan Mason Individual W-2 Managing EmployeeCredentialing Coordinator Sep 26, 2022
Rodney Barry Stout Individual Corporate OfficerChief Executive Officer Jan 1, 2024
Robert Grillo Individual Corporate DirectorBoard Member Oct 17, 2007
Larry Kidd Individual Corporate DirectorBoard Member Feb 12, 2014
Michael R Canady Individual Corporate DirectorBoard Member Jan 1, 2024
Holzer Health System Organization, Gallipolis, OH Operational/Managerial Control Jan 27, 2015
Michael Haynes Individual Corporate OfficerChief Financial Officer Jan 1, 2017
Nicolette M Jones Individual Corporate OfficerChief Medical Officer Jan 1, 2024
Tom Wiseman Individual Corporate DirectorBoard Member Dec 16, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1255768552",
    "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": "740-446-5929",
            "fax_number": "740-446-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 JACKSON AVE",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255501615",
            "telephone_number": "304-675-6380",
            "fax_number": "304-675-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLZER HOSPITAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-446-5051",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WV",
            "license": "APPLIED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Pleasant, WV

Sources for this page

Verify at the official NPI Registry.