Individual provider Active NPI

Jonathan Dwayne Holiday, LADC II

  • Addiction (Substance Use Disorder) Counselor
  • Smyrna, TN
National Provider Identifier
1629849427
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LDC0000001255 Issued in TN
Practice address
4330 Freemark Dr
Smyrna, TN 37167-8417
Phone
(615) 604-6988
NPI assigned
Jan 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LDC0000001255 TN Primary

Addresses

Primary practice location

4330 Freemark Dr
Smyrna, TN 37167-8417

Mailing address

4330 Freemark Dr
Smyrna, TN 37167-8417
Phone (615) 604-6988

Other practice location 1

5511 Virginia Way
Ste 300
Brentwood, TN 37027-7611
Phone (615) 994-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809001726 TN Practitioner - Mental Health Counselor 7517405418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LDC0000001255TNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
National Addiction Specialists LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

5511 Virginia Way
Ste 300
Brentwood, TN 37027
Phone (615) 692-1560

249 Central Park Ave
Ste 300161
Virginia Beach, VA 23462
Phone (615) 994-1000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1629849427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 FREEMARK DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371678417",
            "telephone_number": "615-604-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 FREEMARK DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371678417",
            "telephone_number": "615-604-6988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5511 Virginia Way",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277611",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLIDAY",
        "first_name": "JONATHAN",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "LADC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-10",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC0000001255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.