Active NPI
Byron Ray Hollis
- Pharmacist
- Sacaton, AZ
National Provider Identifier
1649308891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4467
- Practice address
- 483 W. Seed Farm Rd
Sacaton, AZ 85247 - Phone
- (602) 528-1303
- NPI assigned
- Mar 1, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4467 | AZ | Primary |
Addresses
Primary practice location
483 W. Seed Farm Rd
Sacaton, AZ 85247
Mailing address
509 E Sage Brush St
Gilbert, AZ 85296-2328
Phone (480) 497-2248
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4467 | AZ | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649308891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 E SAGE BRUSH ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852962328",
"telephone_number": "480-497-2248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 W. SEED FARM RD",
"city": "SACATON",
"state": "AZ",
"postal_code": "85247",
"telephone_number": "602-528-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIS",
"first_name": "BYRON",
"middle_name": "RAY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "4467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacaton, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.