Holly M Mantooth, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

9074 Issued in TN

Practice address

1 Medical Park Blvd
Bristol, TN 37620-7430

Phone

(423) 844-2855

Fax

(423) 844-2897

NPI assigned

Jan 17, 2011

Last updated

Jan 17, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1649575036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WOODWAY DR",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376175558",
            "telephone_number": "423-323-3047",
            "fax_number": "423-844-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-2855",
            "fax_number": "423-844-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTOOTH",
        "first_name": "HOLLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "9074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Mamo, LCSW
• Jean Marie Mancini, M.D.
• Alister Mann, DO
• Ealon James Mann, DO
• Elyse Suzanne Mann
• Billy Joe Manuel, NCC LPC
• Kitzi Denise Manuel, BS
• Marden Medical, PLLC (Advanced Gynecology & Wellness)
• David W. Marden, DO
• Mary Kathleen Marquette, M.D.

• Pharmacist in Bristol, TN
• Providers in Bristol, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.