Active NPI
Chad D. Holland, PA-C
- Physician Assistant
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2015006588
- Practice address
- 2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239 - Phone
- (417) 820-3960
- Fax
- (417) 820-3966
- NPI assigned
- Mar 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2015006588 | MO | Primary |
Addresses
Primary practice location
2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239
Mailing address
PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | MO | |
| P01509555 | Other | MO | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, TN, KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1235 E Cherokee St
Springfield, MO 65804-2203
Hospital & facility affiliations
- Mercy Hospital Springfield
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6785 | TN | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| Specialty Physician Group LLC | Physician Assistant | Current | Accepting new patients |
| Mercy Clinic Springfield Communities | Past | Accepting new patients |
Locations
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1235 E Cherokee St
Ste 2C
Springfield, MO 65804
Phone (417) 820-3919
2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
1325 Eastmoreland Ave
Ste 365
Memphis, TN 38104
Phone (901) 272-6018
7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792
Organizations & group practices 6
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.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
- Cardiovascular Disease Physician
- Germantown, TN
- NPI 1174842181
Physician Assistant
-
- Family Medicine Physician
- Merriam, KS
- NPI 1992735690
-
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1063805489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505164",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631505164",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 S FREMONT AVE",
"address_2": "SUITE 5000",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042239",
"telephone_number": "417-820-3960",
"fax_number": "417-820-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "CHAD",
"middle_name": "D.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-10",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2015006588",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01509555",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.