Organization Active NPI

Roland Hollis MD

  • Family Medicine Physician
  • Paragould, AR
National Provider Identifier
1962403956
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROLAND HOLLIS MD
Practice address
400 Highway 49 N
Suite 2
Paragould, AR 72450-4007
Phone
(870) 236-1014
Fax
(870) 236-9669
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Mrs. Robin Lynette Hollis, LPN
Title
Office Manager
Phone
(870) 236-1014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

400 Highway 49 N
Suite 2
Paragould, AR 72450-4007

Mailing address

400 Highway 49 N
Suite 2
Paragould, AR 72450-4007
Phone (870) 236-1014

Other identifiers 1

IdentifierTypeStateIssuer
117653001MedicaidAR

National Provider Directory

National Provider Directory

Locations

400 Highway 49 N
Ste 2
Paragould, AR 72450
Phone (870) 236-1014

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1962403956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHWAY 49 N",
            "address_2": "SUITE 2",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504007",
            "telephone_number": "870-236-1014",
            "fax_number": "870-236-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHWAY 49 N",
            "address_2": "SUITE 2",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504007",
            "telephone_number": "870-236-1014",
            "fax_number": "870-236-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLAND HOLLIS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "HOLLIS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-236-1014",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117653001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.