Active NPI
Jacob C. Holloway, APRN-CNP
- Nurse Practitioner
- Washington Court House, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.0030557
- Practice address
- 1430 Columbus Ave
Washington Court House, OH 43160-1703 - Phone
- (740) 335-1210
- NPI assigned
- Mar 7, 2016
- Last updated
- Nov 21, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| AP130409 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland District Hospital | Current | Accepting new patients | |
| Highland District Hospital | Current | Accepting new patients | |
| Hospitalist Medicine Physicians of Ohio - Cincinnati Professional Corp | Nurse Practitioner | Current | 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
- 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.
-
- Emergency Medicine Physician
- Chillicothe, OH
- NPI 1508698739
Nurse Practitioner
-
- Critical Access Hospital
- Hillsboro, OH
- NPI 1225053119
-
dba Highland District Hospital Swing Bed Unit
- Medicare Defined Swing Bed Hospital Unit
- Hillsboro, OH
- NPI 1154699031
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.