Individual provider Active NPI

Kimberly Bryant-Holman, PHARM D

  • Pharmacist
  • Bolivar, TN
National Provider Identifier
1356309298
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10469 Issued in TN
Practice address
640 Nuckolls Rd
Bolivar, TN 38008-1532
Phone
(731) 659-3740
Fax
(731) 659-3741
NPI assigned
May 2, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10469 TN Primary

Addresses

Primary practice location

640 Nuckolls Rd
Bolivar, TN 38008-1532

Mailing address

3395 Old Jackson Rd
Somerville, TN 38068-5829
Phone (901) 465-7902

Other identifiers 1

IdentifierTypeStateIssuer
4437794OtherTNPHARMACY 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 Pharmacy

State licenses

LicenseStateTypeSpecialty
10469TNMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356309298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 OLD JACKSON RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380685829",
            "telephone_number": "901-465-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081532",
            "telephone_number": "731-659-3740",
            "fax_number": "731-659-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT-HOLMAN",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "10469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NUMBER",
            "identifier": "4437794",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.