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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOLON HEALTH GREAT LAKES, P.C.
NPI 1194414805
Family Medicine in Glen Allen, VA

Active since May 08, 2023CLIA Certified · 11 labs
11551 NUCKOLS RD STE R, GLEN ALLEN, VA 23059(877) 465-6650(804) 294-2775 Get Directions Write a Review

NPPES record last updated: October 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2026, Jul 9, 2026, Mar 18, 2026 and 6 more (9 updates tracked since 2023).

About Holon Health Great Lakes, P.c. NPPES

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

HOLON HEALTH GREAT LAKES, P.C. (NPI 1194414805), doing business as Holon Health, is a healthcare organization registered as a family medicine in Glen Allen, Virginia and active in the NPI registry since May 2023. The organization holds 11 active CLIA laboratory certificates, maintains 15 additional practice locations, and lists Jason Herzog, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194414805
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHOLON HEALTH GREAT LAKES, P.C.
Location Address11551 NUCKOLS RD STE RGlen Allen, VA 23059-5565
Mailing Address3540 Pump Rd # 1188Richmond, VA 23233-1115 · (877) 754-4694 · Fax (804) 294-2775
Phone(877) 465-6650
Fax(804) 294-2775
Organization SubpartNo
Authorized OfficialJason HerzogCeo · (877) 754-4694
Enumeration DateMay 8, 2023
Last NPPES UpdateOctober 9, 20269 updates tracked since enumeration
NPPES CertifiedOctober 9, 2026
✔ NPI 1194414805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPreventive Medicine · Addiction MedicineTaxonomy 2083A0300X
Also ListedPsychiatry & Neurology · Addiction PsychiatryTaxonomy 2084P0802X
Also ListedNurse PractitionerTaxonomy 363L00000X
11551 NUCKOLS RD STE R, Glen Allen, VA 23059
Open in Google Maps ↗

Other Names 1

Doing Business AsHolon Health

Secondary Practice Locations 15

Location 11209 Mountain Road Pl NE Ste NAlbuquerque, NM 87110-7845 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 21902 N Date St Ste 100Truth OR Consequences, NM 87901-3701 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 3145 Pine Haven Shores Rd Ste 1000AShelburne, VT 05482-7812 · Phone (877) 754-4694
Location 4212 N 2nd St Ste 100Richmond, KY 40475-1408 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 5116 Agnes Rd Ste 200Knoxville, TN 37919-6306 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 68401 Mayland Dr Ste ARichmond, VA 23294-4648 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 7221 Main St Ste NNashua, NH 03060-2913 · Phone (877) 754-4694
Location 82222 W Grand River Ave Ste AOkemos, MI 48864-1604 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 94030 Wake Forest Rd Ste 349Raleigh, NC 27609-0010 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 104539 N 22nd St Ste NPhoenix, AZ 85016-4639 · Phone (877) 465-6650 · Fax (804) 924-2775
Location 11117 S Lexington St Ste 100Harrisonville, MO 64701-2444 · Phone (877) 465-6650 · Fax (804) 294-2775
Location 121717 N St NW Ste 1Washington, DC 20036-2827 · Phone (877) 754-4694
Location 139905 S Pennsylvania Ave Ste AOklahoma City, OK 73159-6920 · Phone (877) 754-4694
Location 141001 Bishop St Ste 2685AaHonolulu, HI 96813-3429 · Phone (877) 754-4694
Location 155534 Saint Joe RdFort Wayne, IN 46835-3328 · Phone (877) 465-6650 · Fax (804) 294-2775

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holon Health Great Lakes, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

41

Medicare enrollment records show 41 clinicians reassign Medicare billing to Holon Health Great Lakes, P.C., which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Nurse Practitioner27
Clinical Social Worker9
Mental Health Counselor2
Psychiatry2
Marriage and Family Therapist1

Nearest to this location (20)

See all 41
Katie Rood
Nurse Practitioner
NPI 1215690623
3540 PUMP RD
Richmond, VA 23233
(804) 404-6270
✔ PECOS2.8 mi
Erin Tarquinio, NP
Nurse Practitioner
NPI 1831607415
2340 SPRING FOREST RD
Raleigh, NC 27615
(888) 694-7287
✔ PECOS✔ Accepts Medicare138 mi
Brian Still, M.D.
Psychiatry
NPI 1245420314
2700 E PHILLIPS RD
Greer, SC 29650
(843) 754-1066
✔ PECOS✔ Accepts Medicare323 mi
Tara Dillon
Nurse Practitioner
NPI 1124405915
73 MILL ST STE C
Gahanna, OH 43230
(614) 654-0002
✔ PECOS✔ Accepts Medicare327 mi
Jacqueline Fields, ARNP
Nurse Practitioner
NPI 1750319117
506 N MAIN ST
Nicholasville, KY 40356
(833) 510-4357
✔ PECOS✔ Accepts Medicare382 mi
Dominique Driessen Espana, LCSW
Clinical Social Worker
NPI 1598036600
7370 MEMORIAL DRIVE SUITE E-10
Savannah, GA 31406
(843) 422-5290
✔ PECOS435 mi
Amber Garlick, LCSW
Clinical Social Worker
NPI 1235860412
200 JACKSON ST APT 320
Columbus, IN 47201
(812) 371-8595
✔ PECOS463 mi
Wendy Taylor, LCSW
Clinical Social Worker
NPI 1871012989
8320 MADISON AVE
Indianapolis, IN 46227
(317) 882-5122
✔ PECOS480 mi
Cameron Chappell
Nurse Practitioner
NPI 1316571532
1123 DEVONSHIRE EAST DR
Greenwood, IN 46143
(317) 430-5028
✔ PECOS481 mi
Heidijo Elyea
Nurse Practitioner
NPI 1013451509
675 JUSTICE WAY ROOM C0049
Indianapolis, IN 46203
(877) 465-6650
✔ PECOS481 mi
Emily Gibson, NURSE PRACTITIONER
Nurse Practitioner
NPI 1407438146
675 JUSTICE WAY ROOM C0049
Indianapolis, IN 46203
(877) 465-6650
✔ PECOS481 mi
Jennifer Gregory, MSN, PMHNP-BC
Nurse Practitioner
NPI 1679148472
675 JUSTICE WAY ROOM C0049
Indianapolis, IN 46203
(877) 465-6650
✔ PECOS✔ Accepts Medicare481 mi
Victoria Blink, LCAC
Mental Health Counselor
NPI 1619508009
675 JUSTICE WAY RM C0049
Indianapolis, IN 46203
(219) 798-3361
✔ PECOS482 mi
Catherine Obaseki
Clinical Social Worker
NPI 1205614054
912 N DELAWARE ST
Indianapolis, IN 46202
(844) 980-1862
✔ PECOS✔ Accepts Medicare484 mi
Caitlin Hantelman, LCSW
Clinical Social Worker
NPI 1194573550
520 ABACCUS LN
Westfield, IN 46074
(317) 418-1518
✔ PECOS489 mi
Amanda Slaten, LCSW, LCAC
Clinical Social Worker
NPI 1245788363
6655 E US HIGHWAY 36
Avon, IN 46123
(888) 714-1927
✔ PECOS497 mi
Kelly Tucker, LCSW
Clinical Social Worker
NPI 1154459337
3000 MICHAEL LN
Spring Hill, TN 37174
(615) 618-9018
✔ PECOS532 mi
Jessica Peterson, D.O.
Psychiatry
NPI 1871906107
211 NE 54TH ST STE 201
Kansas City, MO 64118
(816) 453-6777
✔ PECOS✔ Accepts Medicare926 mi
Kimberly Koll, LMHC
Mental Health Counselor
NPI 1336641679
181 LESSIE DR
Stonewall, LA 71078
(307) 220-6560
✔ PECOS993 mi
Candice Dogans, LMFT, MAC
Marriage and Family Therapist
NPI 1699186189
3707 E SOUTHERN AVE STE 2058
Mesa, AZ 85206
(480) 678-6039
✔ PECOS1,936 mi
See all 41 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 11

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2332301

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332301
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Traci Sweet Dr
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC211 E Leigh Street, Richmond, VA 23219
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2332303

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332303
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Traci Sweet Dr
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC3220 Enslow Ave, Richmond, VA 23222
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2332305

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332305
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorTraci Sweet
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC1839 Thomas St, Richmond, VA 23220
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2332309

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332309
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Traci Sweet Dr
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC2201 Dinwiddie Ave, Richmond, VA 23224
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2332312

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332312
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Traci Sweet Dr
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC1119 N 27th St, Richmond, VA 23223
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2332314

Holon Health Great Lakes, PC · Richmond, VA
Active · expires Oct 16, 2027
CLIA Number49D2332314
Laboratory TypeTransitional Housing
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Traci Sweet Dr
Laboratory Phone(877) 754-4694
Laboratory LocationHolon Health Great Lakes, PC2812 North Ave, Richmond, VA 23222
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holon Health Great Lakes, P.C.'s NPI number?

The NPI number for Holon Health Great Lakes, P.C. is 1194414805. It was assigned to this organization in the NPPES registry on May 8, 2023. The provider is doing business as Holon Health.

Where is Holon Health Great Lakes, P.C. located?

Holon Health Great Lakes, P.C. is located at 11551 Nuckols Rd Ste R, Glen Allen, VA 23059. The listed phone number is (877) 465-6650.

What is Holon Health Great Lakes, P.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Holon Health Great Lakes, P.C. enrolled in Medicare?

Yes. Holon Health Great Lakes, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Holon Health Great Lakes, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 41 clinicians in 5 Medicare specialties reassign their Medicare billing to Holon Health Great Lakes, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (27), Clinical Social Worker (9) and Mental Health Counselor (2). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Holon Health Great Lakes, P.C. hold CLIA laboratory certificates?

Yes. 11 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Holon Health Great Lakes, P.C. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 1 other insurer list Holon Health Great Lakes, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Holon Health Great Lakes, P.C. was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.