Jack Holland, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

9809402-4406 Issued in UT

Practice address

Heber Valley Hospital
1485 US-40
Heber City, UT 84032

Phone

(435) 654-2500

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Legacy Anesthesia LLC

  • Anesthesiology Physician
  • Heber City, UT
  • NPI 1851764112
  Medicare reassignment
• Burlington Anesthesia PA

  • Anesthesiology Physician
  • Burlington, NC
  • NPI 1538148754

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Durham Anesthesia Associates PA

  • Specialist
  • Durham, NC
  • NPI 1730275744

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Regional Anesthesia, PLLC

  • Specialist
  • Durham, NC
  • NPI 1952486946
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1699755231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 KINGSFORD AVE",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986317",
            "telephone_number": "307-203-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEBER VALLEY HOSPITAL",
            "address_2": "1485 US-40",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "84032",
            "telephone_number": "435-654-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8th Avenue C Street",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841430001",
            "country_code": "US",
            "telephone_number": "801-727-2056",
            "fax_number": "770-701-6675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JACK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "161328",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "821399",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "053081",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "9809402-4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051521",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marci Heugly
• Hidden Piece Counseling LLC
• Kayleigh Hofheins
• Joy Holbrook, APRN
• Suzan Virginia Holdaway, R.N.
• Jade Holmes, CPBD, CPPD, LMT
• Thomas Berry Huffaker
• Sandra Hughes, FNP-C
• Steven Hughes
• Vicki Hunsaker, MS CCC-SLP

• Certified Registered Nurse Anesthetist in Heber City, UT
• Providers in Heber City, UT by specialty
• Certified Registered Nurse Anesthetist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.