Individual provider Active NPI

Jared Holtgrave, DVM

  • Veterinarian
  • Downers Grove, IL
National Provider Identifier
1336564525
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
090010919 Issued in IL
Practice address
2551 Warrenville Rd
Downers Grove, IL 60515-1724
Phone
(630) 963-0424
NPI assigned
Feb 24, 2014
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 090010919 IL Primary

Addresses

Primary practice location

2551 Warrenville Rd
Downers Grove, IL 60515-1724

Mailing address

2551 Warrenville Rd
Downers Grove, IL 60515-1724
Phone (630) 963-0424

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

LicenseStateTypeSpecialty
090010919ILMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1336564525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 WARRENVILLE RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151724",
            "telephone_number": "630-963-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 WARRENVILLE RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151724",
            "telephone_number": "630-963-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTGRAVE",
        "first_name": "JARED",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "IL",
            "license": "090010919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.