Active NPI
Mark John Holland, MD
- General Practice Physician
- Albuquerque, NM
National Provider Identifier
1346400181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 91 65
- Practice address
- 2301 San Pedro Dr NE
Suite B
Albuquerque, NM 87110-4119 - Phone
- (505) 232-6818
- NPI assigned
- Jun 16, 2008
- Last updated
- Nov 12, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 91 65 | NM | Primary |
Addresses
Primary practice location
2301 San Pedro Dr NE
Suite B
Albuquerque, NM 87110-4119
Mailing address
2301 San Pedro Dr NE
Suite B
Albuquerque, NM 87110-4119
Phone (505) 232-6818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91-65 | Other | NM | NEW MEXICO MEDICAL BOARD LICENSE NUMBER |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91 65 | NM | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1346400181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 SAN PEDRO DR NE",
"address_2": "SUITE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104119",
"telephone_number": "505-232-6818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 SAN PEDRO DR NE",
"address_2": "SUITE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104119",
"telephone_number": "505-232-6818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "MARK",
"middle_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-16",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NM",
"license": "91 65",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO MEDICAL BOARD LICENSE NUMBER",
"identifier": "91-65",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.