Individual provider Active NPI

Joan Ellen Holland, RN

  • School Registered Nurse
  • Cheektowaga, NY
National Provider Identifier
1063722403
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
3698831 Issued in NY
Practice address
4635 Union Road
Cheektowaga, NY 14225-1851
Phone
(716) 633-7574
Fax
(716) 817-5220
NPI assigned
Oct 19, 2010
Last updated
Oct 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 3698831 NY Primary

Addresses

Primary practice location

4635 Union Road
Cheektowaga, NY 14225-1851

Mailing address

4635 Union Road
Cheektowaga, NY 14225-1851
Phone (716) 633-7574

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
3698831NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Wny 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1063722403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 UNION ROAD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251851",
            "telephone_number": "716-633-7574",
            "fax_number": "716-817-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 UNION ROAD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251851",
            "telephone_number": "716-633-7574",
            "fax_number": "716-817-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JOAN",
        "middle_name": "ELLEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "3698831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.