Organization Active NPI

Jason a Hollabaugh,DC LLC

  • Chiropractor
  • Youngstown, OH
National Provider Identifier
1679975924
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JASON A HOLLABAUGH,DC LLC
Practice address
7098 Lockwood Blvd Ste 7106
Youngstown, OH 44512-4064
Phone
(330) 953-1858
Fax
(330) 954-0789
NPI assigned
Sep 18, 2014
Organization subpart
No

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

Authorized official

Name
Jason A HollabaughNPI 1669721692
Title
Owner
Phone
(330) 953-1858

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

7098 Lockwood Blvd Ste 7106
Youngstown, OH 44512-4064

Mailing address

7098 Lockwood Blvd Ste 7106
Youngstown, OH 44512-4064
Phone (330) 953-1858

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231011002596 OH Part B Supplier - Clinic/Group Practice 1850746868 Receives reassigned benefits from 1 practitioner
Practice locations: Youngstown, OH

National Provider Directory

National Provider Directory
Tax ID family
Jason a Hollabaugh DC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

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

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

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1679975924",
    "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": "330-953-1858",
            "fax_number": "330-954-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7098 LOCKWOOD BLVD STE 7106",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124064",
            "telephone_number": "330-953-1858",
            "fax_number": "330-954-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON A HOLLABAUGH,DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "HOLLABAUGH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-953-1858"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.