Individual provider Active NPI

Megan M Holland, MD

  • Family Medicine Physician
  • Coquille, OR
National Provider Identifier
1184632366
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD27591 Issued in OR
Practice address
790 E 5TH St
Coquille, OR 97423-1755
Phone
(541) 396-3111
Fax
(541) 396-5891
NPI assigned
Aug 4, 2006
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD27591 OR Primary

Addresses

Primary practice location

790 E 5TH St
Coquille, OR 97423-1755

Mailing address

790 E 5TH St
Coquille, OR 97423-1755
Phone (541) 396-3111

Other identifiers 1

IdentifierTypeStateIssuer
244094MedicaidOR

Other names 1

  • Megan M Stormo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070914000042 OR Practitioner - Family Practice 5193740462 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD27591ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Dec 1, 2011 Accepting new patients
Coquille Valley Hospital District CurrentSince Jul 1, 2019 Accepting new patients
North Bend Medical Center Inc CurrentSince Dec 1, 2011 Accepting new patients
Coquille Valley Hospital District CurrentSince Jul 1, 2019 Accepting new patients

Locations

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

790 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1184632366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231755",
            "telephone_number": "541-396-3111",
            "fax_number": "541-396-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231755",
            "telephone_number": "541-396-3111",
            "fax_number": "541-396-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "MEGAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD27591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244094",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "STORMO",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coquille, OR

Sources for this page

Verify at the official NPI Registry.