Charles Jackson Holland, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME12310 Issued in FL

Practice address

2390 Phillips Road
Tallahassee, FL 32308-5326

Phone

(850) 487-2604

Fax

(850) 922-2123

NPI assigned

Aug 14, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Florida Department of Children and Families

  • Psychiatric Hospital
  • Macclenny, FL
  • NPI 1013931765
  NPD (past)

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1093961666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 PIEDMONT DRIVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323122323",
            "telephone_number": "850-385-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 PHILLIPS ROAD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085326",
            "telephone_number": "850-487-2604",
            "fax_number": "850-922-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "CHARLES",
        "middle_name": "JACKSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME12310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holiday CVS LLC
• Holiday CVS LLC
• Edward Warren Holifield, M.D.
• Diane S Holladay, APRN-C
• Wendy Rebecca Hollady, LCSW
• Gabrielle Holland
• Jemirah Helena Holland, M.S.W.
• Daniel Leighton Hollar, PH.D.
• Dorothy Jean Holley, LCSW
• Tina Michelle Hollie, RN

• Orthopaedic Surgery Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.