MR. RASHAD C. HOLLEY (NPI# 1053684985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053684985 |
| Entity Type | Individual |
| Full Name | MR. RASHAD C. HOLLEY |
| Practice Address |
1225 Villaggio Blvd Bossier City LA 71111-7438 |
| Practice Telephone | 9152698942 |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2012-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
1225 VILLAGGIO BLVD |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-7438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568803450 | Jenna Elizabeth Davila | Military Health Care Provider | 293 Avondale Ln, Bossier City, LA 71112-4266 | 2013-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902318314 | Alexander Arrieta | Military Health Care Provider | 1917 Liberty Ave S, Barksdale Afb, LA 71110-2162 | 2017-10-26 |
| 1043566698 | Mikka Slater | Military Health Care Provider | 1503 University Ave, Monroe, LA 71203-3550 | 2012-08-01 |
| 1033477757 | Shandy Gore | Military Health Care Provider | 5610 Buncombe Rd Apt 907, Shreveport, LA 71129-3617 | 2012-05-01 |
| 1710243126 | Mark Butanis | Military Health Care Provider | 3913 N I 10 Service Rd W Apt 239, Metairie, LA 70002-6828 | 2012-04-10 |
| 1790014660 | Athena Lee Castilleja Ezernack | Military Health Care Provider | 407 Barksdale Blvd E, Barksdale Afb, LA 71110-2125 | 2009-12-23 |
| 1730313602 | Brian W Signal | Military Health Care Provider | 243 Cutiss Rd, 2 Mdg, Barksdale Afb, LA 71110 | 2009-05-07 |
| 1891179578 | Heather C Acres | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2015-07-13 |
| 1598909970 | Jody Lee Ohmer | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| 1194969550 | Charles Wayne Sheffield | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| 1346484805 | Rachonn Shalette Williamson | Military Health Care Provider | 243 Curtiss Rd, St 100 (2amds/sgpf), Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| Find all providers with the same taxonomy | ||||
| City | BOSSIER CITY |
| Zip Code | 71111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.