NPIMap

Individual provider Active NPI

Holly Marie Heyne, FNP-C

  • Family Nurse Practitioner
  • Athol, ID
National Provider Identifier
1003315789
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
59037 Issued in ID
Practice address
7173 E Super 1 Loop
Ste B
Athol, ID 83801
Phone
(208) 561-9901
Fax
(208) 561-9968
NPI assigned
Feb 7, 2018
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 59037 ID Primary
Registered Nurse 163W00000X 47201 ID

Addresses

Primary practice location

7173 E Super 1 Loop
Ste B
Athol, ID 83801

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

Other identifiers 1

IdentifierTypeStateIssuer
1003315789MedicaidID

Other names 1

  • Ms. Holly Collins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180730002168 ID Practitioner - Nurse Practitioner 6204184831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

315 W Dalton Ave
Suite B
Coeur D Alene, ID 83815-8600
Phone (208) 209-2066

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
47201IDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Jul 9, 2018 Accepting new patients
North Idaho Day Surgery LLC PastSince Mar 19, 2023 Accepting new patients
North Idaho Day Surgery LLC PastSince Jul 9, 2018 Accepting new patients

Locations

7173 E Super 1 Loop
Ste B
Athol, ID 83801
Phone (208) 561-9901

315 W Dalton Ave
Ste B
Coeur D Alene, ID 83815
Phone (208) 209-2066

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

Interoperability endpoints

  • Direct secure messaging: hcollins@nwsh.gwaydirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1003315789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7173 E SUPER 1 LOOP",
            "address_2": "STE B",
            "city": "ATHOL",
            "state": "ID",
            "postal_code": "83801",
            "telephone_number": "208-561-9901",
            "fax_number": "208-561-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYNE",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "59037",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "47201",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003315789",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "COLLINS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athol, ID

Sources for this page

Verify at the official NPI Registry.