Jonathan Hollister, MD
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Granville, OH
NPI 1487621652 · NPPES record last updated Aug 14, 2014
Key facts
- NPI
- 1487621652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- 35-08-4535 (OH)
- Practice address
- 590 Newark Granville Rd
Granville, OH 43023-1436 - Phone
- (888) 531-7444
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 15
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Geriatric Medicine
- Education
- Wright State University Boonshoft School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pai Participant 1 LLC
Central Ohio Geriatrics, LLC
Practice addresses (Care Compare)
100 Willow Brook Way S
Delaware, OH 43015-3249
Phone (740) 369-0048
1400 Chapel Way
Heath, OH 43056-1099
Phone (740) 522-4663
2158 Columbus Rd
Granville, OH 43023-1242
Phone (740) 321-0400
230 Cherry St
Chillicothe, OH 45601-2301
Phone (740) 773-6470
25 Noe Bixby Rd
Columbus, OH 43213-1411
Phone (614) 864-3576
4590 Knightsbridge Blvd
Columbus, OH 43214-4327
Phone (614) 451-6793
5055 Thompson Rd
Columbus, OH 43230-6336
Phone (614) 855-3700
5199 E Broad St
Columbus, OH 43213-3800
Phone (614) 751-5700
579 W 5TH Ave
Columbus, OH 43201-3174
Phone (614) 721-2035
6470 Post Rd
Dublin, OH 43016-3267
Phone (614) 602-6749
920 Sharon Valley Rd
Newark, OH 43055-7925
Phone (740) 336-7333
Hospital & facility affiliations
- A Tender Nursing Care Company
- Premier Home Health LLC
- Hallmark Home Care Inc
- National Church Residences H&C Services Central Ohio Hospice
- National Church Residences Home and Community Serv
- Hospice of Central Ohio
- Suncrest Hospice
- Queen City Hospice
- Licking Memorial Hospital
- Adena Regional Medical Center
- Otterbein at Granville
- Mother Angeline McCrory Manor
- Altercare Newark North Inc.
- Altercare Newark South Inc.
- Scioto Rehabilitation & Care Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.63 of 100
- Quality
- 67.26
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Otterbein at Granville |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Dec 1, 2021 Dec 1, 2021 |
| Natl Church Residences Home & Community Serv Southern Ohio Hospice |
Hospice | Contracted Managing Employee | Jul 1, 2017 |
| National Church Residences H&C Services Central Ohio Hospice |
Hospice | Contracted Managing Employee | Jul 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050915000778 | OH | Practitioner - Geriatric Medicine |
4880627256 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pai Participant 1 LLC | Current |
Accepting new patients | |
| Mother Angeline McCrory Manor, Inc. | Past | Accepting new patients | |
| Columbus Colony for Elderly Care Inc. | Past | Accepting new patients | |
| SRCC Operations LLC | Past | Accepting new patients | |
| Altercare Newark South, Inc. | Past | Accepting new patients | |
| Altercare Newark North, Inc. | Past | Accepting new patients |
Locations
230 Cherry St
Chillicothe, OH 45601
Phone (740) 773-6470
2158 Columbus Rd
Granville, OH 43023
Phone (740) 321-0400
Interoperability endpoints
- jonathan.hollister.1@4416.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 35-08-4535 | OH | Yes |
Addresses
Primary practice location
590 Newark Granville Rd
Granville, OH 43023-1436
Mailing address
590 Newark Granville Rd
Granville, OH 43023-1436
Phone (888) 531-7444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2612917 | Medicaid | OH |
NPI Registry JSON
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1487621652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 NEWARK GRANVILLE RD",
"city": "GRANVILLE",
"state": "OH",
"postal_code": "430231436",
"telephone_number": "888-531-7444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 NEWARK GRANVILLE RD",
"city": "GRANVILLE",
"state": "OH",
"postal_code": "430231436",
"telephone_number": "888-531-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLISTER",
"first_name": "JONATHAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "OH",
"license": "35-08-4535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2612917",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
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- Amanda Marie Highman
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- Hannah Holmes
- Brian Vincent Hortz
- Peter D Hucek
- Caryn Lee Huffman
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All providers in Granville, OH · Geriatric Medicine (Family Medicine) Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.