Active NPI
Bradford Owen Holloway, LCSW
- Clinical Social Worker
- Benton, AR
National Provider Identifier
1831157148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 802-C
- Practice address
- 6701 Highway 67
Benton, AR 72015 - Phone
- (501) 315-3344
- NPI assigned
- May 3, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 802-C | AR | Primary |
Addresses
Primary practice location
6701 Highway 67
Benton, AR 72015
Mailing address
PO Box 1589
Benton, AR 72018-1589
Phone (501) 315-3344
Other practice location 1
4171 North Crossover Road
Fayetteville, AR 72703
Phone (479) 684-5326
Other practice location 2
4171 North Crossover Road
Fayetteville, AR 72703
Phone (479) 684-5326
Other practice location 3
1100 N University Ave
Little Rock, AR 72207-6343
Phone (870) 273-2909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55203 | Other | AR | BLUECROSS BLUESHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535587200000",
"number": "1831157148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1589",
"city": "BENTON",
"state": "AR",
"postal_code": "720181589",
"telephone_number": "501-315-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 HIGHWAY 67",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-315-3344"
}
],
"practiceLocations": [
{
"address_1": "4171 North Crossover Road",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "AR",
"postal_code": "72703",
"country_code": "US",
"telephone_number": "479-684-5326",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4171 North Crossover Road",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "AR",
"postal_code": "72703",
"country_code": "US",
"telephone_number": "479-684-5326",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 N University Ave",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722076343",
"country_code": "US",
"telephone_number": "870-273-2909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "BRADFORD",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2018-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "802-C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "55203",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.