Holly Marie Smith

Primary specialty

Meals ProviderTaxonomy code 174200000X

Practice address

4849 Sedona Dr
Eugene, OR 97404-3309

Phone

(541) 337-6976

NPI assigned

Oct 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Holly Marie Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1417590035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HERITAGE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974042691",
            "telephone_number": "541-337-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 SEDONA DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043309",
            "telephone_number": "541-337-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "JOHNSON",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana K Smith, PHD
• Danene R Smith
• Donalee Smith
• Donna Smith
• Grant Andrew Smith, L.D.
• Ian Smith
• Jacqueline Smith
• Jean Louise Smith, PHD
• Jessica Bryce Smith, A.A.S, P.S.S, C.H.W
• Jill L Smith, MA

• Meals Provider in Eugene, OR
• Providers in Eugene, OR by specialty
• Meals Provider in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.