Daniel James Holloway

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

901686 Issued in MS

Practice address

201 Northlake Ave Ste 207
Ridgeland, MS 39157-1717

Phone

(601) 366-4696

NPI assigned

Sep 13, 2016

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 11, 2021 through Nov 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jackson Psychiatry Group

  dba PMT Clinic

  • Psychiatry Physician
  • Ridgeland, MS
  • NPI 1629378971

  Psychiatric/Mental Health

  NPD (past)
• Jackson Psychiatry Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgeland, MS
  • NPI 1790087393
  NPD (past)

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1972051522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NORTHLAKE AVE STE 207",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571717",
            "telephone_number": "601-366-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTHLAKE AVE STE 207",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571717",
            "telephone_number": "601-366-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "901686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis R Holder
• Ashli Holliman, SLP
• Jasmine C. Hollinger, M.D.
• Mary Amber Hollingsworth, OTR/L
• Mary L Hollingsworth, PT
• Felicia Marie Holmes, OTR-L
• Deborah Jones Holt, PHD, LMSW
• Hilarie Nixon Holt, OD
• Homecare Plus, Inc.
• Jessica Lee Honan, OTR-L

• Psychiatric/Mental Health Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.