Holly Allen, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN226149 Issued in GA

Practice address

460 Northside Cherokee Blvd Ste 100
Canton, GA 30115-8017

Phone

(770) 292-3490

Fax

(770) 721-5615

NPI assigned

Dec 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990

  GA

  Medicare reassignment Care Compare group NPD

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1003388679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158017",
            "telephone_number": "770-292-3490",
            "fax_number": "770-721-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158017",
            "telephone_number": "770-292-3490",
            "fax_number": "770-721-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "HOLLY",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN226149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birmaji Ali, MD
• Syed Faizan Ali, M.D.
• Alive Touch Health Center
• Abeer Alkhaldi
• Barbara B. Allen, WHNP
• Jaedyn Allen, DC
• Robert Lee Allen, M.D.
• Sarah P Allen, ED.S., CCC-SLP
• Taiwo Alonge
• Morgan Altamirano, AGACNP-C

• All providers in Canton, GA
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.