Individual provider Active NPI

Robert Austin Holeman, R,PH.

  • Pharmacist
  • Joplin, MO
National Provider Identifier
1821270034
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2005033292 Issued in MO
Practice address
495 N Simmental LN
Joplin, MO 64801-8661
Phone
(417) 206-4324
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2005033292 MO Primary
Pharmacist 183500000X 1-09508 KS
Pharmacist 183500000X PD-10193 AR

Addresses

Primary practice location

495 N Simmental LN
Joplin, MO 64801-8661

Mailing address

495 N Simmental LN
Joplin, MO 64801-8661
Phone (417) 206-4324

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
PD-10193ARMDPharmacist
1-09508KSMDPharmacist
2005033292MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1821270034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N SIMMENTAL LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648018661",
            "telephone_number": "417-206-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N SIMMENTAL LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648018661",
            "telephone_number": "417-206-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEMAN",
        "first_name": "ROBERT",
        "middle_name": "AUSTIN",
        "credential": "R,PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2005033292",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-09508",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD-10193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.