Individual provider Active NPI

Lisa Marie Holle, PHARMD

  • Pharmacist
  • Storrs, CT
National Provider Identifier
1609169523
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0011838 Issued in CT
Practice address
1232 Storrs Rd
#6
Storrs, CT 06268-2232
Phone
(860) 634-3697
NPI assigned
May 25, 2011
Last updated
May 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0011838 CT Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PCT.0011838 CT
Oncology Pharmacist 1835X0200X PCT.0011838 CT

Addresses

Primary practice location

1232 Storrs Rd
#6
Storrs, CT 06268-2232

Mailing address

69 N Eagleville Rd
Unit 3092
Storrs, CT 06269-3092
Phone (860) 634-3697

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PCT.0011838CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1609169523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 N EAGLEVILLE RD",
            "address_2": "UNIT 3092",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062693092",
            "telephone_number": "860-634-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 STORRS RD",
            "address_2": "#6",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062682232",
            "telephone_number": "860-634-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLE",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0011838",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "PCT.0011838",
            "primary": false
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CT",
            "license": "PCT.0011838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storrs, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.