Active NPI
Deasa Holly
- Exclusive Provider Organization
- Cincinnati, OH
National Provider Identifier
1376091629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- License
- 302F00000X
- Practice address
- 2473 Timbercroft CT
Cincinnati, OH 45239-6614 - Phone
- (513) 680-3371
- NPI assigned
- Sep 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 302F00000X | OH | Primary |
Addresses
Primary practice location
2473 Timbercroft CT
Cincinnati, OH 45239-6614
Mailing address
2473 Timbercroft CT
Cincinnati, OH 45239-6614
Phone (513) 680-3371
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
| License | State | Type | Specialty |
|---|---|---|---|
| 302F00000X | OH | MD | Exclusive Provider Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1376091629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2473 TIMBERCROFT CT",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452396614",
"telephone_number": "513-680-3371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2473 TIMBERCROFT CT",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452396614",
"telephone_number": "513-680-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLY",
"first_name": "DEASA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-15",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "OH",
"license": "302F00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.