Individual provider Active NPI

Jacob C. Holloway, APRN-CNP

  • Nurse Practitioner
  • Washington Court House, OH
National Provider Identifier
1851751630
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0030557 Issued in OH
Practice address
1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone
(740) 335-1210
NPI assigned
Mar 7, 2016
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0030557 OH Primary
Family Nurse Practitioner 363LF0000X AP130409 TX

Addresses

Primary practice location

1430 Columbus Ave
Washington Court House, OH 43160-1703

Mailing address

1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone (740) 335-1210

Other practice location 1

1040 W Jefferson St
Brownsville, TX 78520-6338
Phone (956) 350-2844

Other practice location 2

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 3

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 4

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 5

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 6

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 7

600 W Main St
Troy, OH 45373-3384
Phone (937) 980-7010

Other practice location 8

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 9

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Other practice location 10

1 Kettering Way
Piqua, OH 45356-4146
Phone (937) 916-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220325001998 OH Practitioner - Nurse Practitioner 0749562163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP130409TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highland District Hospital CurrentSince Apr 27, 2022 Accepting new patients
Highland District Hospital CurrentSince Apr 27, 2022 Accepting new patients
Hospitalist Medicine Physicians of Ohio - Cincinnati Professional Corp Nurse Practitioner CurrentSince Oct 10, 2024 Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

1430 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2705

Interoperability endpoints

  • FHIR API: https://epicscripts.trihealth.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1851751630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLUMBUS AVE",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431601703",
            "telephone_number": "740-335-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 COLUMBUS AVE",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431601703",
            "telephone_number": "740-335-1210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 W Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TX",
            "postal_code": "785206338",
            "country_code": "US",
            "telephone_number": "956-350-2844",
            "fax_number": "956-350-0999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8000",
            "fax_number": "614-293-3124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453564146",
            "country_code": "US",
            "telephone_number": "937-916-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "JACOB",
        "middle_name": "C.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-07",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0030557",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington Court House, OH

Sources for this page

Verify at the official NPI Registry.