Active NPI
Derek Holyoak
- Student in an Organized Health Care Education/Training Program
- Chandler, AZ
National Provider Identifier
1720959604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- I027084
- Practice address
- 975 E Ocotillo Rd
Chandler, AZ 85249-3013 - Phone
- (480) 214-1367
- Fax
- (480) 214-1370
- NPI assigned
- Sep 15, 2025
- Last updated
- Sep 15, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | I027084 | AZ | Primary |
Addresses
Primary practice location
975 E Ocotillo Rd
Chandler, AZ 85249-3013
Mailing address
975 E Ocotillo Rd
Chandler, AZ 85249-3013
Phone (480) 214-1367
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
| License | State | Type | Specialty |
|---|---|---|---|
| I027084 | AZ | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1757894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757894400000",
"number": "1720959604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 E OCOTILLO RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852493013",
"telephone_number": "480-214-1367",
"fax_number": "480-214-1370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 E OCOTILLO RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852493013",
"telephone_number": "480-214-1367",
"fax_number": "480-214-1370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLYOAK",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-15",
"last_updated": "2025-09-15",
"certification_date": "2025-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "I027084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.