NPIMap

Organization Active NPI

Fred Jamie W Holland II MD PC

Doing business as Cardiothoracic and Vascular Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Erie, PA
National Provider Identifier
1053407023
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
FRED JAMIE W HOLLAND II MD PC
Doing business as
Cardiothoracic and Vascular Surgery
Practice address
2314 Sassafras St
Suite 305
Erie, PA 16502-2722
Phone
(814) 456-9197
Fax
(814) 455-2765
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jamie Holland, MD
Title
Ceo
Phone
(814) 456-9197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

2314 Sassafras St
Suite 305
Erie, PA 16502-2722

Mailing address

3530 Peach St
Suite LL1
Erie, PA 16508-2768
Phone (814) 860-5000

Other identifiers 1

IdentifierTypeStateIssuer
1014522940002MedicaidPA

Other names 1

  • Cardiothoracic and Vascular Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

2314 Sassafras St
Ste 305
Erie, PA 16502
Phone (814) 452-7246

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053407023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 PEACH ST",
            "address_2": "SUITE LL1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082768",
            "telephone_number": "814-860-5000",
            "fax_number": "814-860-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 SASSAFRAS ST",
            "address_2": "SUITE 305",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022722",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED JAMIE W HOLLAND II MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-456-9197",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014522940002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiothoracic and Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.