Individual provider Active NPI

Holly Michelle Tissue-Thompson, PHARMD.

  • Pharmacist
  • Grove City, PA
National Provider Identifier
1235452384
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP045555L Issued in PA
Practice address
1566 W Main Street Ext
Grove City, PA 16127-4432
Phone
(724) 458-5977
NPI assigned
Mar 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP045555L PA Primary

Addresses

Primary practice location

1566 W Main Street Ext
Grove City, PA 16127-4432

Mailing address

204 Shields Rd
Slippery Rock, PA 16057-1818
Phone (724) 735-2694

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
RP045555LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1235452384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 SHIELDS RD",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160571818",
            "telephone_number": "724-735-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 W MAIN STREET EXT",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274432",
            "telephone_number": "724-458-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISSUE-THOMPSON",
        "first_name": "HOLLY",
        "middle_name": "MICHELLE",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP045555L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.