Jennifer Rachelle Holman, RD/LD-CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD1057 Issued in OK

Practice address

408 S Cherry St
Sallisaw, OK 74955-6602

Phone

(918) 774-5074

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jennifer Rachelle Bailey-Holman Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment Care Compare group NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Nowata, OK
  • NPI 1891703716
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD
• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  Care Compare affiliation
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1417069782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S CHERRY ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749556602",
            "telephone_number": "918-774-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S CHERRY ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749556602",
            "telephone_number": "918-774-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "JENNIFER",
        "middle_name": "RACHELLE",
        "credential": "RD/LD-CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "LD1057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200057610A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHCA DDSD WAIVER",
            "identifier": "200057610B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B",
            "identifier": "8E279B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BAILEY-HOLMAN",
            "middle_name": "RACHELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bridget Lanelle Hicks
• Thomas John Hicks
• Magen Hill
• Vickey Hodge
• Billy Wayne Holley, MSW, LCSW
• Misty Dawn Holmes
• Homecare Clinicians LLC (Elara Caring XVIII)
• Jennifer Honeycutt, MA
• Amanda Artist Horn
• Melissa Ann Horn, FNP

• Registered Dietitian in Sallisaw, OK
• Providers in Sallisaw, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.