Active NPI
John Todd Holland, D.O.
- Psychiatry Physician
- Blacksburg, VA
National Provider Identifier
1215469630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0102205920
- Practice address
- 107 Church St NE
Unit N5
Blacksburg, VA 24060 - Phone
- (540) 998-1349
- Fax
- (224) 253-5465
- NPI assigned
- Apr 3, 2017
- Last updated
- Feb 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0102205920 | VA | Primary |
Addresses
Primary practice location
107 Church St NE
Unit N5
Blacksburg, VA 24060
Mailing address
107 Church St NE
Unit N5
Blacksburg, VA 24060
Phone (540) 998-1349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 2, 2023 through Feb 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102205920 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John T Holland, DO | Psychiatry | Current | Accepting new patients |
Organizations & group practices 1
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": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1215469630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 CHURCH ST NE",
"address_2": "UNIT N5",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "24060",
"telephone_number": "540-998-1349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 CHURCH ST NE",
"address_2": "UNIT N5",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "24060",
"telephone_number": "540-998-1349",
"fax_number": "224-253-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "JOHN",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-03",
"last_updated": "2024-02-21",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0102205920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.