Active NPI
Holly Marie Acree, CPHT
- Pharmacy Technician
- Bloomington, IL
National Provider Identifier
1104417336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 049274554
- Practice address
- 2225 W Market St
Bloomington, IL 61705-5014 - Phone
- (309) 828-8626
- NPI assigned
- Jan 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 67031856A | IN | |
| Pharmacy Technician | 183700000X | 049274554 | IL | Primary |
Addresses
Primary practice location
2225 W Market St
Bloomington, IL 61705-5014
Mailing address
417 Greenbriar Dr Apt 3
Normal, IL 61761-2232
Phone (573) 462-9139
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
| License | State | Type | Specialty |
|---|---|---|---|
| 049274554 | IL | MD | Pharmacy Technician |
| 67031856A | IN | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611964800000",
"number": "1104417336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 GREENBRIAR DR APT 3",
"city": "NORMAL",
"state": "IL",
"postal_code": "617612232",
"telephone_number": "573-462-9139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 W MARKET ST",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617055014",
"telephone_number": "309-828-8626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACREE",
"first_name": "HOLLY",
"middle_name": "MARIE",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-30",
"last_updated": "2021-01-30",
"certification_date": "2021-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IN",
"license": "67031856A",
"primary": false
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IL",
"license": "049274554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
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- Acupuncture Medical Solutions, Inc.
- Flora Leatrice Adams-Williams, P.A.-C
- Candice Fern Adams, M.A.CCC-SLP/L
- Kayla Adams, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.