NPIMap

Individual provider Active NPI

Samuel Allen Holstein

  • Peer Specialist
  • Chesapeake, OH
National Provider Identifier
1578299459
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
9 Chesapeake PLZ
Chesapeake, OH 45619-1003
Phone
(740) 340-1602
NPI assigned
Jul 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

9 Chesapeake PLZ
Chesapeake, OH 45619-1003

Mailing address

120 W Main St
Circleville, OH 43113-1654
Phone (304) 533-8304

Other practice location 1

900 20th St
Huntington, WV 25703-1810
Phone (681) 378-3908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Resource Group CurrentSince Jul 1, 2022 Accepting new patients
Phoenix Group Home, LLC CurrentSince Jul 28, 2024 Accepting new patients
Phoenix Group Home, LLC PastSince Jul 28, 2024 Accepting new patients
Path Integrated Healthcare - WV LLC Past Accepting new patients
Jason a. Moore, D.C. PLLC PastSince Jul 1, 2022 Accepting new patients

Locations

3 Chesapeake Plz
#9
Chesapeake, OH 45619

9 Chesapeake Plz
Chesapeake, OH 45619
Phone (740) 297-6019

900 20th St
Huntington, WV 25703
Phone (681) 378-3908

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations & group practices 5

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1578299459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131654",
            "telephone_number": "304-533-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHESAPEAKE PLZ",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456191003",
            "telephone_number": "740-340-1602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 20th St",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257031810",
            "country_code": "US",
            "telephone_number": "681-378-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSTEIN",
        "first_name": "SAMUEL",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.