Individual provider Active NPI

Johanna Grace Hollweg, D.O.

  • Gastroenterology Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1871856757
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
1138 Issued in NE
Practice address
3551 Roger Brooke Dr
Quality Services Attn: McHe-ZQQ
Jbsa Ft Sam Houston, TX 78234-4504
Phone
(210) 916-3647
Fax
(210) 916-3195
NPI assigned
Jun 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1138 NE
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 1138 NE Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Quality Services Attn: McHe-ZQQ
Jbsa Ft Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-3647

Other names 1

  • Dr. Johanna Grace Hollweg Marowske Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222003365 MT Practitioner - Gastroenterology 2860782083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP Billings - Missoula LLC Current Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

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": "1339804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1871856757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3647",
            "fax_number": "210-916-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "QUALITY SERVICES ATTN: MCHE-ZQQ",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3647",
            "fax_number": "210-916-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLWEG",
        "first_name": "JOHANNA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-16",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "1138",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "1138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "MAROWSKE",
            "middle_name": "GRACE HOLLWEG",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.