Individual provider Active NPI

Katherine Jones Holsworth

  • Dental Hygienist
  • Jackson, MI
National Provider Identifier
1780910240
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902015485 Issued in MI
Practice address
7040 McKay Rd
Jackson, MI 49201-9261
Phone
(517) 740-5620
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2902015485 MI Primary
Dental Hygienist 124Q00000X 4877 TN

Addresses

Primary practice location

7040 McKay Rd
Jackson, MI 49201-9261

Mailing address

304 W Antoine St
Iron Mountain, MI 49801-1314

Other names 1

  • Mary Katherine Jones Former name

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
2902015485MIMDDental Hygienist
4877TNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1780910240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W ANTOINE ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 MCKAY RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019261",
            "telephone_number": "517-740-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSWORTH",
        "first_name": "KATHERINE",
        "middle_name": "JONES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902015485",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "4877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JONES",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.