Active NPI
Kaisha Holloway
- Clinic/Center
- Browns Mills, NJ
National Provider Identifier
1306221023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- H62824248251912
- Practice address
- 605 Sandra Drive
Browns Mills, NJ 08015 - Phone
- (609) 379-1705
- NPI assigned
- Jul 23, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | H62824248251912 | NJ | Primary |
Addresses
Primary practice location
605 Sandra Drive
Browns Mills, NJ 08015
Mailing address
605 Sandra Dr
Browns Mills, NJ 08015-3769
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H62824248251912 | NJ | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1306221023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 SANDRA DR",
"city": "BROWNS MILLS",
"state": "NJ",
"postal_code": "080153769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 SANDRA DRIVE",
"city": "BROWNS MILLS",
"state": "NJ",
"postal_code": "08015",
"telephone_number": "609-379-1705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "KAISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NJ",
"license": "H62824248251912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Browns Mills, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.