Individual provider Active NPI

Jennifer Lynn Holan, MD

  • Obstetrics & Gynecology Physician
  • Bloomfield Hills, MI
National Provider Identifier
1750343406
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
JH062815 Issued in MI
Practice address
1750 S Telegraph Rd
Suite 108
Bloomfield Hills, MI 48302-0166
Phone
(248) 858-2202
Fax
(248) 334-4517
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X JH062815 MI Primary
Obstetrics & Gynecology Physician 207V00000X 22616 AZ
Obstetrics & Gynecology Physician 207V00000X G80257 CA

Addresses

Primary practice location

1750 S Telegraph Rd
Suite 108
Bloomfield Hills, MI 48302-0166

Mailing address

1750 S Telegraph Rd
Suite 108
Bloomfield Hills, MI 48302-0166
Phone (248) 858-2202

Other identifiers 1

IdentifierTypeStateIssuer
3084274MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22616AZMDObstetrics & Gynecology Physician
G80257CAMDObstetrics & Gynecology Physician
JH062815MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pontiac Associates in Obstetrics & Gynecology, P.C. Obstetrics & Gynecology PastSince Jan 1, 1994 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1750343406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S TELEGRAPH RD",
            "address_2": "SUITE 108",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020166",
            "telephone_number": "248-858-2202",
            "fax_number": "248-334-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S TELEGRAPH RD",
            "address_2": "SUITE 108",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020166",
            "telephone_number": "248-858-2202",
            "fax_number": "248-334-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "JH062815",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "22616",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G80257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084274",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.