Active NPI
Hailey Marlyce Holland, MFCS, RDN, LD
- Registered Dietitian
- North Liberty, IA
National Provider Identifier
1639740558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86050880
- Practice address
- 143 War Admiral LN
North Liberty, IA 52317-2005 - Phone
- (507) 456-3974
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86050880 | IA | Primary |
Addresses
Primary practice location
143 War Admiral LN
North Liberty, IA 52317-2005
Mailing address
143 War Admiral LN
North Liberty, IA 52317-2005
Phone (507) 456-3974
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86050880 | IA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Interoperability endpoints
- hholland211530@uihcdirect.org
Organizations & group practices 2
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": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1639740558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 WAR ADMIRAL LN",
"city": "NORTH LIBERTY",
"state": "IA",
"postal_code": "523172005",
"telephone_number": "507-456-3974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 WAR ADMIRAL LN",
"city": "NORTH LIBERTY",
"state": "IA",
"postal_code": "523172005",
"telephone_number": "507-456-3974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "HAILEY",
"middle_name": "MARLYCE",
"credential": "MFCS, RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2021-07-02",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "86050880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Liberty, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.