KEITH G HOLLEY (NPI# 1386616183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386616183 |
| Entity Type | Individual |
| Full Name | KEITH G HOLLEY |
| Credential | MD |
| Practice Address |
4424 E Flamingo Ave Suite 110 Nampa ID 83687 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2082884700 |
| Practice Fax Number | 2082884720 |
| Mailing Telephone | 2083675170 |
| Mailing Fax Number | 2083675180 |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2014-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
M-11367 | ID | Allopathic & Osteopathic Physicians |
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
MD00045579 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1386616183 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922377605 | Keith Alan Holley | Pharmacist | 11010 Bloomingdale Ave, Riverview, FL 33578-3617 | 2011-12-23 |
| 1801872866 | Keith E Holley | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-21 |
| Street Address |
4424 E FLAMINGO AVE SUITE 110 |
| City | NAMPA |
| State | ID |
| Zip Code | 83687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356339618 | Randolph C Byrd | Internal Medicine | 4424 E Flamingo Ave, Suite 300, Nampa, ID 83687-9306 | 2005-10-11 |
| 1154840270 | Emma Nelson | Physical Therapist | 4424 E Flamingo Ave, Nampa, ID 83687-9289 | 2017-09-11 |
| 1750839502 | Boyd Layton | Physician Assistant | 4424 E Flamingo Ave, Suite 110, Nampa, ID 83687-9289 | 2016-09-21 |
| 1386191500 | Tarasue C Maness | Nurse Practitioner | 4424 E Flamingo Ave, Ste 310, Nampa, ID 83687 | 2016-09-06 |
| 1477932523 | Steen Edwards | Physical Therapist | 4424 E Flamingo Ave, Nampa, ID 83687-9289 | 2015-05-22 |
| 1477949261 | John Lattin | Physical Medicine & Rehabilitation | 4424 E Flamingo Ave, Suite 310, Nampa, ID 83687 | 2015-04-08 |
| 1588084453 | Jeffery Reese | Obstetrics & Gynecology | 4424 E Flamingo Ave, Ste 200, Nampa, ID 83687 | 2014-04-18 |
| 1588096804 | Branson J Collins | Anesthesiology | 4424 E Flamingo Ave, Nampa, ID 83687-9289 | 2013-08-09 |
| 1033473285 | Purushothaman Muthusamy | Internal Medicine | 4424 E Flamingo Ave, Ste 300, Nampa, ID 83687 | 2012-07-02 |
| 1639214216 | Tosha Jo Johnson | Nurse Practitioner | 4424 E Flamingo Ave, Suite 300, Nampa, ID 83687-9306 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307447 | Current Physical Therapy Nampa LLC | Physical Therapist | 16150 N High Desert Street, Nampa, ID 83687 | 2020-02-10 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1750828513 | Daniel & Max, LLC | Optometrist | 1600 Karcher Rd, Nampa, ID 83687 | 2017-01-31 |
| 1578965422 | Jorge Domingo Reyes | Counselor | 5700 E. Franklin Rd., Suite 220-i, Nampa, ID 83687 | 2014-09-23 |
| 1619302080 | David Lyle Farris | Dentist | 16548 North Franklin Blvd., Nampa, ID 83687 | 2013-09-04 |
| 1871934547 | Ian Zafar Qureshi | Internal Medicine | 4400 E Flamingo Ave Ste 130, Nampa, ID 83687 | 2013-07-10 |
| 1457696783 | Laurel Evans | Specialist/Technologist | 850 W. St. Luke's Dr., Suite 215, Nampa, ID 83687 | 2012-11-27 |
| 1750641197 | Andrea Patricia Fitzer | Nurse Practitioner | 4400 E. Flamingo Ave, Nampa, ID 83687 | 2012-05-18 |
| 1679846182 | Ivony Case Management | Case Management | 811 12th Street, Ste. 2, Nampa, ID 83687 | 2012-02-14 |
| 1699043679 | Saltzer Medical Group, P.a. | Durable Medical Equipment & Medical Supplies | 9850 W St Lukes Drive, Nampa, ID 83687 | 2011-12-06 |
| Find all providers in zip 83687 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306874763 | Gregory Edwin Biddulph | Orthopaedic Surgery | 3300 Washington Pkwy, Idaho Falls, ID 83404-7592 | 2006-06-28 |
| 1578955621 | Dallco Orthopaedics & Sports Medicine | Orthopaedic Surgery | 3300 Washington Pkwy, Idaho Falls, ID 83404-7592 | 2015-02-26 |
| 1689896433 | Jason Dalling | Orthopaedic Surgery | 3300 Washington Pkwy, Idaho Falls, ID 83404-7592 | 2007-05-02 |
| 1215948104 | Colin E Poole | Orthopaedic Surgery | 600 N Robbins Rd, Ste 100, Boise, ID 83702-4566 | 2006-08-10 |
| 1679584577 | Dennis R Mcgee | Orthopaedic Surgery | 6165 W Emerald Street, Boise, ID 83704-8613 | 2006-08-10 |
Please comment or provide details below to improve the information on KEITH G HOLLEY.
| 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.