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DEREK HOLLAND
NPI 1164164778
Student in an Organized Health Care Education/Training Program in Louisville, KY

Active since April 13, 2022PECOS Enrolled
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202(502) 550-8533 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Derek Holland NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK HOLLAND (NPI 1164164778) is an individual student in an organized health care education/training program in Louisville, Kentucky and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164164778
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDEREK HOLLAND
Location Address500 S PRESTON ST RM 305Louisville, KY 40202-1702
Mailing Address500 S Preston St Rm 305Louisville, KY 40202-1702
Phone(502) 550-8533
Sole ProprietorNo
Enumeration DateApril 13, 2022
NPPES CertifiedApril 13, 2022
✔ NPI 1164164778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
500 S PRESTON ST RM 305, Louisville, KY 40202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Holland is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIANNE GRACE SCHULTZ
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (703) 677-1433
CHELSEA FATHAUER
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (812) 560-7611
QUENTIN VIRGIL WISE
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (323) 640-1105
SYMONE JORDAN
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (502) 852-5193
CALEB X HE
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (859) 878-5655
RAHAF ALREFAI
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (502) 810-4028
AUSTIN GREGORY CLARK
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (502) 202-0106
JOHN R DODDS
Student in an Organized Health Care Education/Training Program
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202
Jefferson County (270) 339-1091

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Holland's NPI number?

The NPI number for Derek Holland is 1164164778. It was assigned to this individual provider in the NPPES registry on April 13, 2022.

Where is Derek Holland located?

Derek Holland practices at 500 S Preston St Rm 305, Louisville, KY 40202. The listed phone number is (502) 550-8533.

What is Derek Holland's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Derek Holland enrolled in Medicare?

Yes. Derek Holland is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derek Holland was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.