Active NPI
Keith Francis Holliday, R.N.
- Registered Nurse
- Frederick, MD
National Provider Identifier
1821130378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0001171808
- Practice address
- 1434 Porter St
Frederick, MD 21702-9210 - Phone
- (301) 619-0345
- NPI assigned
- Feb 13, 2007
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001171808 | VA | Primary |
Addresses
Primary practice location
1434 Porter St
Frederick, MD 21702-9210
Mailing address
125 Seurat LN
Martinsburg, WV 25401-7683
Phone (304) 262-2559
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001171808 | VA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821130378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 SEURAT LN",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254017683",
"telephone_number": "304-262-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1434 PORTER ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217029210",
"telephone_number": "301-619-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIDAY",
"first_name": "KEITH",
"middle_name": "FRANCIS",
"name_prefix": "Mr.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001171808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.