Active NPI
Brandon Alan Hollister, PH.D., L.L.C.
- Psychologist
- Omaha, NE
National Provider Identifier
1578077459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 943
- Practice address
- 11414 W Center Rd
Omaha, NE 68144-4486 - Phone
- (402) 333-8210
- NPI assigned
- Nov 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 943 | NE | Primary |
Addresses
Primary practice location
11414 W Center Rd
Omaha, NE 68144-4486
Mailing address
21410 McClellan Cir
Gretna, NE 68028-6910
Phone (402) 460-7282
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 943 | NE | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511913600000",
"number": "1578077459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21410 MCCLELLAN CIR",
"city": "GRETNA",
"state": "NE",
"postal_code": "680286910",
"telephone_number": "402-460-7282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11414 W CENTER RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681444486",
"telephone_number": "402-333-8210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLISTER",
"first_name": "BRANDON",
"middle_name": "ALAN",
"credential": "PH.D., L.L.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-29",
"last_updated": "2017-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.