Individual provider Active NPI

Alisa Yvette Holder, LPN

  • Licensed Practical Nurse
  • Indianapolis, IN
National Provider Identifier
1023398955
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
27062306A Issued in IN
Practice address
5954 Hillside Avenue West Dr
Indianapolis, IN 46220-2418
Phone
(317) 362-2910
NPI assigned
Aug 23, 2011
Last updated
Aug 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27062306A IN Primary

Addresses

Primary practice location

5954 Hillside Avenue West Dr
Indianapolis, IN 46220-2418

Mailing address

5954 Hillside Avenue West Dr
Indianapolis, IN 46220-2418
Phone (317) 362-2910

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27062306AINMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1023398955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5954 HILLSIDE AVENUE WEST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202418",
            "telephone_number": "317-362-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 HILLSIDE AVENUE WEST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202418",
            "telephone_number": "317-362-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "ALISA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27062306A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.