Individual provider Active NPI

Jo Ann Holland, R.D., L.D.,C.D.E.

  • Registered Dietitian
  • Lawton, OK
National Provider Identifier
1154494888
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
650619
Practice address
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone
(580) 354-5240
Fax
(580) 354-5105
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 650619 Primary

Addresses

Primary practice location

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002

Mailing address

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5240

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1154494888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5240",
            "fax_number": "580-354-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5240",
            "fax_number": "580-354-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JO",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.,C.D.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "650619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.