Active NPI
Bruce Edward Holaday, D.C.
- Sports Physician Chiropractor
- Fairfield, OH
National Provider Identifier
1962586230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 1698
- Practice address
- 2336 Mack Rd
Suite K
Fairfield, OH 45014-8678 - Phone
- (513) 829-1991
- Fax
- (513) 829-1974
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 1698 | OH | Primary |
Addresses
Primary practice location
2336 Mack Rd
Suite K
Fairfield, OH 45014-8678
Mailing address
2336 Mack Road
Suite K
Fairfield, OH 45014
Phone (513) 829-1991
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1698 | OH | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962586230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 MACK ROAD",
"address_2": "SUITE K",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "45014",
"telephone_number": "513-829-1991",
"fax_number": "513-829-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2336 MACK RD",
"address_2": "SUITE K",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450148678",
"telephone_number": "513-829-1991",
"fax_number": "513-829-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLADAY",
"first_name": "BRUCE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "OH",
"license": "1698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
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.