JOSEPH WALTER HOLDHEIDE
NPI 1093650590
Student in an Organized Health Care Education/Training Program in Jackson, MI

Q: What is Joseph Holdheide's NPI number?

The NPI number for Joseph Holdheide is 1093650590. It was assigned to this individual provider in the NPPES registry on April 21, 2026.

Q: What is Joseph Holdheide's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Joseph Holdheide was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 21, 2026PECOS Enrolled

205 N EAST AVE, JACKSON, MI 49201(517) 205-4800 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 27, 2026, Apr 21, 2026 (2 updates tracked since 2026).

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About Joseph Walter Holdheide NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSEPH WALTER HOLDHEIDE (NPI 1093650590) is an individual student in an organized health care education/training program in Jackson, Michigan, licensed in Michigan (5151017841) and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093650590

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJOSEPH WALTER HOLDHEIDE

Location Address205 N EAST AVEJackson, MI 49201-1753

Mailing Address205 N East AveJackson, MI 49201-1753

Phone(517) 205-4800

Sole ProprietorYes

Enumeration DateApril 21, 2026

Last NPPES UpdateApril 27, 20262 updates tracked since enumeration

NPPES CertifiedApril 27, 2026

✔ NPI 1093650590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in MI · 5151017841

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

205 N EAST AVE, Jackson, MI 49201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joseph Walter Holdheide is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA RENE DANEK PA-C

Physician Assistant