Individual provider Active NPI

Jeffrey Holm

  • Pharmacist
  • Charlotte, MI
National Provider Identifier
1477039725
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302042846 Issued in MI
Practice address
1167 E Clinton TRL
Charlotte, MI 48813-7318
Phone
(517) 541-9210
NPI assigned
Jul 18, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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

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

LicenseStateTypeSpecialty
5302042846MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Mar 13, 2022 Accepting new patients
Walgreen Co Past Accepting new patients
Meijer Inc PastSince Oct 27, 2019 Accepting new patients
Meijer Inc PastSince Oct 27, 2019 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302042846 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

1167 E Clinton TRL
Charlotte, MI 48813-7318

Mailing address

1167 E Clinton TRL
Charlotte, MI 48813-7318
Phone (517) 541-9210

Other practice location 1

605 North Ave
Battle Creek, MI 49017-3230
Phone (269) 660-1198

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 25, 2019.

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1477039725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 E CLINTON TRL",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488137318",
            "telephone_number": "517-541-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 E CLINTON TRL",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488137318",
            "telephone_number": "517-541-9210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 North Ave",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490173230",
            "country_code": "US",
            "telephone_number": "269-660-1198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLM",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.