Individual provider Active NPI

Melissa Holland, D.O.

  • Pediatrics Physician
  • Baton Rouge, LA
National Provider Identifier
1679007298
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
323897 Issued in LA
Practice address
8415 Goodwood Blvd Ste 100
Baton Rouge, LA 70806-7851
Phone
(225) 765-5500
Fax
(225) 765-5634
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 323897 LA Primary

Addresses

Primary practice location

8415 Goodwood Blvd Ste 100
Baton Rouge, LA 70806-7851

Mailing address

8415 Goodwood Blvd Ste 100
Baton Rouge, LA 70806-7851
Phone (225) 765-5500

Other practice location 1

5000 Hennessy Blvd
Our Lady of the Lake Med Ctr -Dept of Pediatrics
Baton Rouge, LA 70808-4375
Phone (225) 765-5927

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mholland79679@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803001227 LA Practitioner - Pediatric Medicine 0345665774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
323897LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics CurrentSince Aug 31, 2020 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Aug 31, 2020 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Woman'S Hospital Foundation Past Accepting new patients

Locations

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

8415 Goodwood Blvd
Ste 100
Baton Rouge, LA 70806
Phone (225) 765-5633

8200 Constantin Blvd
Fl 4
Baton Rouge, LA 70809

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8415 Goodwood Blvd
Ste 202
Baton Rouge, LA 70806
Phone (225) 765-8013

Interoperability endpoints

  • Direct secure messaging: mholland79679@direct.casso.us.com

Organizations & group practices 4

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1679007298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-5634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Hennessy Blvd",
            "address_2": "Our Lady of the Lake Med Ctr -Dept of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084375",
            "country_code": "US",
            "telephone_number": "225-765-5927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "MELISSA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "323897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mholland79679@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mholland79679@direct.casso.us.com",
            "address_1": "8415 Goodwood Blvd Ste 100",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8415 Goodwood Blvd Ste 100",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.