Individual provider Active NPI

Oba Hashim Hollie, M.D.

  • Internal Medicine Physician
  • Clarksville, TN
National Provider Identifier
1013130749
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000045168 Issued in TN
Practice address
511 8TH St
Clarksville, TN 37040-3093
Phone
(931) 245-3580
Fax
(931) 201-5868
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000045168 TN Primary

Addresses

Primary practice location

511 8TH St
Clarksville, TN 37040-3093

Mailing address

511 8TH St
Clarksville, TN 37040-3093
Phone (931) 245-3580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000371 TN Practitioner - Internal Medicine 8527105493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000045168TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince May 24, 2021 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince May 24, 2021 Accepting new patients

Locations

511 8th St
Clarksville, TN 37040
Phone (615) 595-8383

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1013130749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 8TH ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403093",
            "telephone_number": "931-245-3580",
            "fax_number": "931-201-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 8TH ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403093",
            "telephone_number": "931-245-3580",
            "fax_number": "931-201-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIE",
        "first_name": "OBA",
        "middle_name": "HASHIM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000045168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.