Individual provider Active NPI

Jessica Holland

  • Registered Dietitian
  • Sitka, AK
National Provider Identifier
1003244435
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
318 Issued in AK
Practice address
222 Tongass Dr
Sitka, AK 99835-9416
Phone
(907) 966-2411
NPI assigned
Oct 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 318 AK Primary

Addresses

Primary practice location

222 Tongass Dr
Sitka, AK 99835-9416

Mailing address

PO Box 240252
Anchorage, AK 99524-0252
Phone (907) 917-0818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509000690 TX Practitioner - Registered Dietitian Or Nutrition Professional 3173822418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
318AKMDRegistered Dietitian

Practice roles (9 of 11)

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Jul 8, 2016 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Jul 8, 2016 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

2000 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-8700

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Networks

  • TX HMO
  • TX HMO D-SNP

Organizations & group practices 9

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": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1003244435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240252",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995240252",
            "telephone_number": "907-917-0818",
            "fax_number": "907-339-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.