Individual provider Active NPI

Jessie L Holland, PHARMD

  • Pharmacist
  • Apache Junction, AZ
National Provider Identifier
1346657152
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020610 Issued in AZ
Practice address
2440 S Ironwood Dr
Apache Junction, AZ 85120-7652
Phone
(480) 288-0428
NPI assigned
Jul 14, 2014
Last updated
Jul 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020610 AZ Primary

Addresses

Primary practice location

2440 S Ironwood Dr
Apache Junction, AZ 85120-7652

Mailing address

1925 S Coronado Rd
Apartment 1154
Gilbert, AZ 85295-1390
Phone (478) 230-9809

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
S020610AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1346657152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 S CORONADO RD",
            "address_2": "APARTMENT 1154",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951390",
            "telephone_number": "478-230-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 S IRONWOOD DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851207652",
            "telephone_number": "480-288-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JESSIE",
        "middle_name": "L",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.