Holly Jo L Hodges, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD19870 Issued in OR

Practice address

2995 Ryan Drive, SE
Suite #200
Salem, OR 97301

Phone

(503) 371-7701

Fax

(503) 371-8046

NPI assigned

Feb 24, 2006

Last updated

Oct 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Holly Jo Ledgerwood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1518933902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N. SHASTA LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97405",
            "telephone_number": "541-343-0079",
            "fax_number": "541-636-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 RYAN DRIVE, SE",
            "address_2": "SUITE #200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-371-7701",
            "fax_number": "503-371-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "HOLLY JO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082201",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY JO",
            "last_name": "LEDGERWOOD",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Nicole Hockema, BS, RDH, EPDH
• Katherine M Hoda, MD
• Diana Hodapp, OTR/L
• Dennis Lee Hodgdon, QMHA
• Cathy Hodges, RPH
• Jessica Lynn Hodges, LMT
• Timothy C. Hodges, MD
• Abigail Heppner Hodgson, D.C.
• Lauren A Hodgson, PA-C
• Bryan H Hodson, MA, LPC

• Family Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.