Individual provider Active NPI

Jason A Hollabaugh, D.C.

  • Chiropractor
  • Boardman, OH
National Provider Identifier
1669721692
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4296 Issued in OH
Practice address
7098 Lockwood Blvd Ste 7106
Boardman, OH 44512-4064
Phone
(330) 953-1858
Fax
(330) 954-0789
NPI assigned
Sep 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X AJ010434 PA
Chiropractor 111N00000X DC010641 PA
Chiropractor 111N00000X 4296 OH Primary

Addresses

Primary practice location

7098 Lockwood Blvd Ste 7106
Boardman, OH 44512-4064

Mailing address

7098 Lockwood Blvd Ste 7106
Youngstown, OH 44512-4064
Phone (330) 507-5533

Other identifiers 1

IdentifierTypeStateIssuer
0098380MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130615000142 OH Practitioner - Chiropractic 4486893807 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Campbell, OH; Poland, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7098 Lockwood Blvd
Suite 7106
Youngstown, OH 44512-4064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4296OHMDChiropractor
AJ010434PAMDChiropractor
DC010641PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jason a. Hollabaugh D.C. LLC Chiropractor CurrentSince May 22, 2013 Accepting new patients
Jason a Hollabaugh,DC LLC Chiropractor CurrentSince Jul 11, 2023 Accepting new patients

Locations

7098 Lockwood Blvd
Ste 7106
Youngstown, OH 44512
Phone (330) 953-1858

7098 Lockwood Blvd
#7106
Youngstown, OH 44512
Phone (330) 953-1858

1040 S Commons Pl
Ste 101
Youngstown, OH 44514
Phone (330) 726-9962

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 2

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": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1669721692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7098 LOCKWOOD BLVD STE 7106",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124064",
            "telephone_number": "330-507-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7098 LOCKWOOD BLVD STE 7106",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124064",
            "telephone_number": "330-953-1858",
            "fax_number": "330-954-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLABAUGH",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "AJ010434",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010641",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098380",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.