Active NPI
Brent J Holleran, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Bonita Springs, FL
National Provider Identifier
1710148382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 01028032A
- Practice address
- 26240 Mira Way
Bonita Springs, FL 34134-1637 - Phone
- (239) 498-7852
- NPI assigned
- Jun 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 01028032A | IN | Primary |
Addresses
Primary practice location
26240 Mira Way
Bonita Springs, FL 34134-1637
Mailing address
26240 Mira Way
Bonita Springs, FL 34134-1637
Phone (239) 498-7852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1710148382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26240 MIRA WAY",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341341637",
"telephone_number": "239-498-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26240 MIRA WAY",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341341637",
"telephone_number": "239-498-7852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLERAN",
"first_name": "BRENT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "IN",
"license": "01028032A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.