Individual provider Active NPI

Ira Janhavi Holla, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Lansing, MI
National Provider Identifier
1982019345
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
27617 Issued in MS
Practice address
901 E Mount Hope Ave
Lansing, MI 48910-3207
Phone
(517) 267-3400
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 27617 MS Primary
Pediatrics Physician 208000000X 4301105296 MI

Addresses

Primary practice location

901 E Mount Hope Ave
Lansing, MI 48910-3207

Mailing address

2500 N State St
Cbo Suite 4200
Jackson, MS 39216-4500
Phone (601) 984-6426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200910000381 MS Practitioner - Pediatric Medicine 5698193563 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301105296MIMDPediatrics Physician
27617MSMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 3, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 3, 2020 Accepting new patients
North Mississippi Medical Center Current Accepting new patients

Locations

2500 N State St
Ste 4200
Jackson, MS 39216

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: iraholla@nmhs.medalliesdirect.net
  • Direct secure messaging: iholla157630@ummc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1982019345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "CBO SUITE 4200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103207",
            "telephone_number": "517-267-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLA",
        "first_name": "IRA",
        "middle_name": "JANHAVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MS",
            "license": "27617",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301105296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.