Individual provider Active NPI

Amanda Kaye Holder, R.N.

  • Registered Nurse
  • Mobile, AL
National Provider Identifier
1154554715
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
152140 Issued in MO
Practice address
7856 Westside Park Dr
Ste C
Mobile, AL 36695-8541
Phone
(251) 633-8090
Fax
(251) 633-8864
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 152140 MO Primary
Registered Nurse 163W00000X R881325 MS
Infusion Therapy Registered Nurse 163WI0500X 152140 MO
Infusion Therapy Registered Nurse 163WI0500X R881325 MS

Addresses

Primary practice location

7856 Westside Park Dr
Ste C
Mobile, AL 36695-8541

Mailing address

7856 Westside Park Dr
Ste C
Mobile, AL 36695-8541
Phone (251) 633-8090

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
152140MOMDInfusion Therapy Registered Nurse
R881325MSMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1154554715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7856 WESTSIDE PARK DR",
            "address_2": "STE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958541",
            "telephone_number": "251-633-8090",
            "fax_number": "251-633-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7856 WESTSIDE PARK DR",
            "address_2": "STE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958541",
            "telephone_number": "251-633-8090",
            "fax_number": "251-633-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "AMANDA",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "152140",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R881325",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MO",
            "license": "152140",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MS",
            "license": "R881325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.