Individual provider Active NPI

M'Chae Hollowell, CCMA, CPT

  • Phlebology Physician
  • Santa Ana, CA
National Provider Identifier
1548789407
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
H8N7F6J6 Issued in CA
Practice address
405 W 5TH St
Santa Ana, CA 92701-4599
Phone
(714) 834-4144
NPI assigned
Sep 12, 2017
Last updated
Sep 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X W9D2A7M8 CA
Phlebology Physician 202K00000X H8N7F6J6 CA Primary

Addresses

Primary practice location

405 W 5TH St
Santa Ana, CA 92701-4599

Mailing address

1045 Sandgrouse LN
Perris, CA 92571-7707
Phone (714) 723-9203

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
H8N7F6J6CAMDPhlebology Physician
W9D2A7M8CAMDPhlebology Physician

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1548789407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 SANDGROUSE LN",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925717707",
            "telephone_number": "714-723-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-834-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWELL",
        "first_name": "M'CHAE",
        "credential": "CCMA, CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CA",
            "license": "W9D2A7M8",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CA",
            "license": "H8N7F6J6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.