Organization Active NPI

Tom Holley, MD, Inc.

  • Child & Adolescent Psychiatry Physician
  • Albuquerque, NM
National Provider Identifier
1659427615
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
77-45 Issued in NM
Legal business name
TOM HOLLEY, MD, INC.
Practice address
1216 Alcazar St NE
Goldsmith
Albuquerque, NM 87110-7108
Phone
(505) 232-9516
Fax
(505) 232-9516
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Dr. Thomas R. Holley, MD
Title
Owner, Psychiatrist
Phone
(505) 232-9516

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 77-45 NM
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 77-45 NM Primary

Addresses

Primary practice location

1216 Alcazar St NE
Goldsmith
Albuquerque, NM 87110-7108

Mailing address

1216 Alcazar St NE
Goldsmith
Albuquerque, NM 87110-7108
Phone (505) 232-9516

Other identifiers 1

IdentifierTypeStateIssuer
25478MedicaidNM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1659427615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 ALCAZAR ST NE",
            "address_2": "GOLDSMITH",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107108",
            "telephone_number": "505-232-9516",
            "fax_number": "505-232-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 ALCAZAR ST NE",
            "address_2": "GOLDSMITH",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107108",
            "telephone_number": "505-232-9516",
            "fax_number": "505-232-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM HOLLEY, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER, PSYCHIATRIST",
        "authorized_official_telephone_number": "505-232-9516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "77-45",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NM",
            "license": "77-45",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25478",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.