Tara D Holy, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1025875 Issued in MI

Practice address

26878 White Oak St
Edwardsburg, MI 49112-9631

Phone

(989) 330-5292

NPI assigned

Sep 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Danielle McComas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1154044071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26878 WHITE OAK ST",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129631",
            "telephone_number": "989-330-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26878 WHITE OAK ST",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129631",
            "telephone_number": "989-330-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLY",
        "first_name": "TARA",
        "middle_name": "D",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "1025875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MCCOMAS",
            "middle_name": "DANIELLE",
            "credential": "RDN, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Edwardsburg, MI
• Providers in Edwardsburg, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.