Individual provider Active NPI

Cynthia J Holifield VI

  • Durable Medical Equipment & Medical Supplies
  • Demopolis, AL
National Provider Identifier
1700988102
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
627 Issued in AL
Practice address
915 Hwy 80 East
Demopolis, AL 36732
Phone
(334) 289-2242
Fax
(334) 289-2241
NPI assigned
Sep 5, 2006
Last updated
Nov 15, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 627 AL Primary

Addresses

Primary practice location

915 Hwy 80 East
Demopolis, AL 36732

Mailing address

915 Hwy 80 East
Demopolis, AL 36732
Phone (334) 289-2242

Other identifiers 1

IdentifierTypeStateIssuer
515-41261OtherALBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
627ALMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia J Holifield Durable Medical Equipment & Medical Supplies Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1700988102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HWY 80 EAST",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "36732",
            "telephone_number": "334-289-2242",
            "fax_number": "334-289-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HWY 80 EAST",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "36732",
            "telephone_number": "334-289-2242",
            "fax_number": "334-289-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIFIELD",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "name_suffix": "VI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-41261",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Demopolis, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.