Individual provider Active NPI

John B Hollis, M.S.W., L.I.S.W.

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1376694539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0005415 Issued in OH
Practice address
1555 Bethel Rd
Columbus, OH 43220-2003
Phone
(614) 442-0664
Fax
(614) 442-0620
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0005415 OH Primary

Addresses

Primary practice location

1555 Bethel Rd
Columbus, OH 43220-2003

Mailing address

1555 Bethel Rd
Columbus, OH 43220-2003
Phone (614) 442-0664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000572 OH Practitioner - Clinical Social Worker 6901063601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio State University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Enliven Resources LLCGroup PAC ID 9537304530, 3 clinicians
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians

Practice addresses (Care Compare)

929 Harrison Ave
Columbus, OH 43215-1300
Phone (614) 940-4868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0005415OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Oct 10, 2025 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Oct 10, 2025 Accepting new patients

Locations

929 Harrison Ave
Ste 200
Columbus, OH 43215
Phone (614) 940-4868

444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300

Interoperability endpoints

  • Direct secure messaging: john.hollis.1@26020.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376694539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202003",
            "telephone_number": "614-442-0664",
            "fax_number": "614-442-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202003",
            "telephone_number": "614-442-0664",
            "fax_number": "614-442-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "M.S.W., L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0005415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.