NPIMap

Organization Active NPI

Supportive Healthcare Skilled LLC

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1316838352
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SUPPORTIVE HEALTHCARE SKILLED LLC
Practice address
4001 Rosslyn Dr
Cincinnati, OH 45209-1111
Phone
(513) 314-7617
NPI assigned
Jul 9, 2025
Last updated
Jul 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Josh Holzman
Title
Ceo
Phone
(513) 314-7617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4001 Rosslyn Dr
Cincinnati, OH 45209-1111

Mailing address

4850 Smith Rd Ste 250
Cincinnati, OH 45212-2733

Other practice location 1

212 Main St
Florence, KY 41042-2269
Phone (513) 314-7617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260112003186 OH Part B Supplier - Clinic/Group Practice 0446736185 Receives reassigned benefits from 62 practitioners
Practice locations: Harrison, OH; Cincinnati, OH; Fairfield Township, OH; Fairfield, OH; Liberty TWP, OH; Loveland, OH; Mason, OH; Medina, OH…
O20260202003193 KY Part B Supplier - Clinic/Group Practice 0446736185 Receives reassigned benefits from 3 practitioners
Practice locations: Augusta, KY; Villa Hills, KY; Ft Wright, KY; Fort Thomas, KY; Falmouth, KY; Erlanger, KY; Florence, KY

National Provider Directory

National Provider Directory

Locations

5799 Bridgetown Rd
Cincinnati, OH 45248
Phone (513) 401-7156

630 W Main St
Ste 209
Wilmington, OH 45177
Phone (937) 382-8500

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1316838352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SMITH RD STE 250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 ROSSLYN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091111",
            "telephone_number": "513-314-7617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Main St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410422269",
            "country_code": "US",
            "telephone_number": "513-314-7617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPPORTIVE HEALTHCARE SKILLED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "HOLZMAN",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-314-7617"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.