Active NPI
Gwynne Gala Holz, M.D.
- Diagnostic Radiology Physician
- Ann Arbor, MI
National Provider Identifier
1912960857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301051288
- Practice address
- 1500 East Medical Center Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109 - Phone
- (734) 936-4500
- NPI assigned
- Apr 11, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4301051288 | MI | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 35059514H | OH |
Addresses
Primary practice location
1500 East Medical Center Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 936-4000
Other practice location 1
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (800) 223-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0141948 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35059514H | OH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cleveland Clinic Florida a Nonprofit Corporation | Past | Accepting new patients | |
| Clinic Physician Services Co. LLC | Past | Accepting new patients |
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.
-
- Clinic/Center
- Weston, FL
- NPI 1215989298
-
- Anesthesiology Physician
- Mayfield HTS, OH
- NPI 1235127408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1912960857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-936-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 EAST MEDICAL CENTER DR",
"address_2": "B1 FLOOR UNIVERSITY HOSPITAL RECP C",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48109",
"telephone_number": "734-936-4500"
}
],
"practiceLocations": [
{
"address_1": "9500 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441950001",
"country_code": "US",
"telephone_number": "800-223-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLZ",
"first_name": "GWYNNE",
"middle_name": "GALA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-11",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301051288",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35059514H",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0141948",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.