Dallas Renae Holladay

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO195999 Issued in OR

Practice address

1046 6TH Ave SW
Albany, OR 97321-1916

Phone

(541) 812-4000

NPI assigned

Mar 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dallas Renae Smith Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275

  Emergency Medicine

  Medicare reassignment NPD
• Providence Health & Services Oregon

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963

  Emergency Medicine

  Medicare reassignment NPD
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Seaside, OR
  • NPI 1578500492
  Medicare reassignment NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Foundation for Emergency Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1467468280
  Medicare reassignment NPD
• Northwest Emergency Physicians LLC

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370

  OR

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527
  Medicare reassignment
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Newberg, OR
  • NPI 1174074868

  Emergency Medicine

  NPD
• Providence Health & Services Oregon

  • Clinical Pathology Physician
  • Seaside, OR
  • NPI 1093266769

  Emergency Medicine

  NPD
• Providence Health & Services Oregon

  • Clinical Pathology Physician
  • Milwaukie, OR
  • NPI 1578014239

  Emergency Medicine

  NPD
• Providence Health & Services Oregon

  • Psychiatric Hospital Unit
  • Milwaukie, OR
  • NPI 1659751360
  NPD
• Providence Health & Services Oregon

  • Rural Health Clinic/Center
  • Warrenton, OR
  • NPI 1972039170
  NPD

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1871834382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 6TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211916",
            "telephone_number": "541-812-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20201 Crawford Ave",
            "address_2": "ATTN: Postdoctoral Education",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "708-747-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLADAY",
        "first_name": "DALLAS",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO195999",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036139497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dholladay267434@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DALLAS",
            "last_name": "SMITH",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janet Ann Hodel, PT
• Melindy Ann Hoeckle, BS, QMHA
• Katrina G Hoffman, FNP
• Clare Hogan
• Seishiro Hokazono, LAC
• Matthew Ryan Holland
• Judith Hollenberg, RN
• Thomas David Hollowell, PA-C
• Kyle A Holmes, QMHA-1, CADC-1, PSS
• Macy J Holmes, LCSW

• Emergency Medicine Physician in Albany, OR
• Providers in Albany, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.