Active NPI
Holly McDaniel, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Mesa, AZ
National Provider Identifier
1013937689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 40735
- Practice address
- 1400 S Dobson Rd
Mesa, AZ 85202-4707 - Phone
- (602) 685-5211
- Fax
- (602) 685-5325
- NPI assigned
- Jul 19, 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 |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | 40735 | AZ | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 40735 | AZ | Primary |
Addresses
Primary practice location
1400 S Dobson Rd
Mesa, AZ 85202-4707
Mailing address
PO Box 42210
Phoenix, AZ 85080-2210
Phone (623) 266-7770
Other practice location 1
2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (602) 685-5211
Other practice location 2
424 S 56th St Ste 120
Phoenix, AZ 85034-2177
Phone (602) 685-5211
Other practice location 3
424 S 56th St Ste 110
Phoenix, AZ 85034-2177
Phone (602) 685-5211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 371009 | Medicaid | AZ |
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 |
|---|---|---|---|
| 40735 | AZ | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonoran Radiology LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Vascular & Interventional Radiology Physician
- Mesa, AZ
- NPI 1033745708
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1013937689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 42210",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850802210",
"telephone_number": "623-266-7770",
"fax_number": "623-322-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325"
}
],
"practiceLocations": [
{
"address_1": "2946 E Banner Gateway Dr",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852342165",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "424 S 56th St Ste 120",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850342177",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "424 S 56th St Ste 110",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850342177",
"country_code": "US",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDANIEL",
"first_name": "HOLLY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "AZ",
"license": "40735",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AZ",
"license": "40735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "371009",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.