Organization Active NPI

Gerry Palmer Holland DO PLLC

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1497999692
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3033 Issued in OK
Legal business name
GERRY PALMER HOLLAND DO PLLC
Practice address
1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone
(405) 272-6084
Fax
(405) 272-6928
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Authorized official

Name
Gerry Palmer Holland, D.O.NPI 1356381891
Title
Owner
Phone
(806) 355-9595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3033 OK Primary

Addresses

Primary practice location

1000 N Lee Ave
Oklahoma City, OK 73102-1036

Mailing address

PO Box 803
Amarillo, TX 79105-0803
Phone (806) 355-9595

Other identifiers 1

IdentifierTypeStateIssuer
200243700AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090602000346 OK Part B Supplier - Clinic/Group Practice 4284784885 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1705 Renaissance Blvd
Ste 16
Edmond, OK 73013
Phone (405) 844-3280

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1497999692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791050803",
            "telephone_number": "806-355-9595",
            "fax_number": "806-353-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-272-6084",
            "fax_number": "405-272-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERRY PALMER HOLLAND DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "GERRY",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-355-9595",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200243700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.