Organization Active NPI

Holyhills Healthcare Services LLC

  • Adult Health Nurse Practitioner
  • Reynoldsburg, OH
National Provider Identifier
1407395692
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1457502502 Issued in OH
Legal business name
HOLYHILLS HEALTHCARE SERVICES LLC
Practice address
6760 Tussing Rd
#104
Reynoldsburg, OH 43068-4129
Phone
(614) 441-2231
NPI assigned
Feb 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Nana Akua Dwomo, FNPNPI 1457502502
Title
C.E.O
Phone
(614) 441-2231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 1457502502 OH Primary

Addresses

Primary practice location

6760 Tussing Rd
#104
Reynoldsburg, OH 43068-4129

Mailing address

6760 Tussing Road
#104
Columbus, OH 43068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411001122 OH Part B Supplier - Clinic/Group Practice 8628354461 Receives reassigned benefits from 8 practitioners
Practice locations: Reynoldsburg, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2136137Holyhills Healthcare Services, LLC6760 Tussing Rd, Reynoldsburg, OH 43068Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory

Locations

6760 Tussing Rd
Ste 104
Reynoldsburg, OH 43068
Phone (614) 377-4592

450 Alkyre Run
Westerville, OH 43082
Phone (614) 382-4313

Practitioners & affiliated clinicians

Practitioners 11

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": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1407395692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 TUSSING ROAD",
            "address_2": "#104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 TUSSING RD",
            "address_2": "#104",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684129",
            "telephone_number": "614-441-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLYHILLS HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "DWOMO",
        "authorized_official_first_name": "NANA AKUA",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "614-441-2231",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "1457502502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.