NPIMap

Individual provider Active NPI

Jonathan Hollister, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Granville, OH
National Provider Identifier
1487621652
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
35-08-4535 Issued in OH
Practice address
590 Newark Granville Rd
Granville, OH 43023-1436
Phone
(888) 531-7444
NPI assigned
Mar 7, 2006
Last updated
Aug 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 35-08-4535 OH Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915000778 OH Practitioner - Geriatric MedicinePractitioner - Family Practice 4880627256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
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 LLCGroup PAC ID 8123351954, 174 clinicians
Central Ohio Geriatrics, LLCGroup PAC ID 7517015373, 8 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
93.63 of 100Reported as apm
Quality
67.26
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Aug 16, 2024 Accepting new patients
Altercare Newark North, 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
Mother Angeline McCrory Manor, 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

  • Direct secure messaging: jonathan.hollister.1@4416.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Otterbein at GranvilleGranville, OH, CCN 366314 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2021
Dec 1, 2021
Natl Church Residences Home & Community Serv Southern Ohio HospiceChillicothe, OH, CCN 361629 Hospice Contracted Managing Employee Jul 1, 2017
National Church Residences H&C Services Central Ohio HospiceDublin, OH, CCN 361640 Hospice Contracted Managing Employee Jul 1, 2017

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granville, OH

Sources for this page

Verify at the official NPI Registry.