Individual provider Active NPI

Joanne Marie Holland, M.D.

  • Family Medicine Physician
  • Drain, OR
National Provider Identifier
1306926274
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20989 Issued in OR
Practice address
117 Third Street
Drain, OR 97435
Phone
(541) 836-2371
Fax
(541) 836-2374
NPI assigned
Oct 16, 2006
Last updated
Aug 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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 20989 OR Primary

Addresses

Primary practice location

117 Third Street
Drain, OR 97435

Mailing address

740 Hidden Spring LN
Drain, OR 97435-9754
Phone (541) 836-2371

Other identifiers 2

IdentifierTypeStateIssuer
D2223-01OtherORPACIFICSOURCE
269574MedicaidOR

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
I20041207000323 OR Practitioner - General PracticePractitioner - Family Practice 3870559388 Practice locations: Drain, OR

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
University of Wisconsin School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 3Rd St
Drain, OR 97435-0210
Phone (541) 836-2371

740 Hidden Spring LN
Drain, OR 97435-9754

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20989ORMDFamily Medicine Physician

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1306926274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 HIDDEN SPRING LN",
            "city": "DRAIN",
            "state": "OR",
            "postal_code": "974359754",
            "telephone_number": "541-836-2371",
            "fax_number": "541-836-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 THIRD STREET",
            "city": "DRAIN",
            "state": "OR",
            "postal_code": "97435",
            "telephone_number": "541-836-2371",
            "fax_number": "541-836-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "20989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICSOURCE",
            "identifier": "D2223-01",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269574",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drain, OR

Sources for this page

Verify at the official NPI Registry.