Individual provider Active NPI

Kyle Holloway, PHARMD

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1194032938
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00007480 Issued in NM
Practice address
2501 Buena Vista Dr SE
Suite 1400
Albuquerque, NM 87106-4260
Phone
(505) 923-5504
Fax
(505) 923-6922
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00007480 NM Primary

Addresses

Primary practice location

2501 Buena Vista Dr SE
Suite 1400
Albuquerque, NM 87106-4260

Mailing address

2501 Buena Vista Dr SE
Suite 1400
Albuquerque, NM 87106-4260
Phone (505) 923-5504

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP00007480NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1194032938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 BUENA VISTA DR SE",
            "address_2": "SUITE 1400",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064260",
            "telephone_number": "505-923-5504",
            "fax_number": "505-923-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 BUENA VISTA DR SE",
            "address_2": "SUITE 1400",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064260",
            "telephone_number": "505-923-5504",
            "fax_number": "505-923-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00007480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.