NPIMap

Organization Active NPI

Holon Health Great Lakes, P.C.

  • Peer Specialist
  • Flagstaff, AZ
National Provider Identifier
1295525608
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
HOLON HEALTH GREAT LAKES, P.C.
Practice address
2314 N 4TH St Ste C
Flagstaff, AZ 86004-3709
Phone
(877) 465-6650
Fax
(804) 294-2775
NPI assigned
May 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Jason Herzog
Title
Ceo
Phone
(804) 955-5246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

2314 N 4TH St Ste C
Flagstaff, AZ 86004-3709

Mailing address

3540 Pump Rd # 1188
Richmond, VA 23233-1115
Phone (804) 955-5246

Other names 1

  • Holon Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Holon Health8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2314 N 4th St
Ste C
Flagstaff, AZ 86004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1295525608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 PUMP RD # 1188",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232331115",
            "telephone_number": "804-955-5246",
            "fax_number": "804-294-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 N 4TH ST STE C",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043709",
            "telephone_number": "877-465-6650",
            "fax_number": "804-294-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLON HEALTH GREAT LAKES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-955-5246"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holon Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.