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Deactivated NPI 1003852765 Deactivated / Inactive NPI Female Practitioner

Dr. Renae Holland , MD

Pediatrics • Provo, UT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Renae Holland has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 21, 2006
NPI Deactivation Date September 27, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Renae Holland, MD was a registered Pediatrics practicing in Provo, UT. Throughout an active medical career spanning 18 years, Dr. Holland provided care at the practice location at 1300 E CENTER ST until profile deactivation on 2024-09-27.

Practice Location & Contact Primary Location

Practice Address

1300 E Center St
Utah State Hospital

Provo, UT 846063554

Telephone 8013444311
Fax 8013444225
Associated Practice Facility / Clinic
🏢 State Of Utah Facility NPI 1811978620

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Provo, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.9 Yrs
Regional Practice Density
24 Specialists

Practicing in Provo, UT (688 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License UT 1790421205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

38 Associated Practitioners
Dr. Edward Kelly , MD

Psychiatry & Neurology - Forensic Psychiatry

NPI 1013995471

Doctor of Medicine (M.D.)

Brett Mortensen , CMHC

Counselor - Mental Health

NPI 1053921536
Dr. John Bench , MD

Psychiatry & Neurology - Psychiatry

NPI 1114905965

Doctor of Medicine (M.D.)

Dr. Gina Lewis , MD

Psychiatry & Neurology - Psychiatry

NPI 1144266321

Doctor of Medicine (M.D.)

Dr. Karl Neilson , MD

Neurological Surgery

NPI 1164616520

Doctor of Medicine (M.D.)

Melissa Timpson , LCSW

Social Worker - Clinical

NPI 1164728473

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 27, 2024

Record deactivated on September 27, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1300 E CENTER ST, UTAH STATE HOSPITAL, PROVO, UT 846063554 (Tel: 8013444311)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 270, PROVO, UT 846060270 (Tel: 8013444311)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RENAE HOLLAND, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #1790421205 in UT)

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Initial NPI Registration & Enumeration June 21, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003852765
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 21, 2006
Last Update: July 08, 2007
Deactivation Date: September 27, 2024

Mailing Address

Po Box 270

Provo, UT 846060270

Phone: 8013444311

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.