NPIMap

Individual provider Active NPI

Holly E Harmon, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oblong, IL
National Provider Identifier
1013579820
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.019582 Issued in IL
Practice address
1366 E 1050TH Ave
Oblong, IL 62449-2409
Phone
(618) 592-3119
Fax
(618) 546-2602
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.019582 IL Primary

Addresses

Primary practice location

1366 E 1050TH Ave
Oblong, IL 62449-2409

Mailing address

1366 E 1050TH Ave
Oblong, IL 62449-2409
Phone (618) 592-3119

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL crawfordmh.org Direct
Direct Messaging Address holly.harmon@crawfordmh.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191104001250 IL Practitioner - Nurse Practitioner 3971835380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crawford Hospital DistrictGroup PAC ID 7719898071, 71 clinicians

Practice addresses (Care Compare)

104 N Garfield St
Oblong, IL 62449-1426
Phone (618) 592-3119

Hospital & facility affiliations

  • Crawford Memorial Hospital Hospital, Robinson, IL, CCN 141343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.019582ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Hospital District CurrentSince Oct 7, 2019 Accepting new patients
Crawford Hospital District CurrentSince Oct 7, 2019 Accepting new patients

Locations

1366 E 1050th Ave
Oblong, IL 62449
Phone (618) 592-3119

1002 N Allen St
Ste B
Robinson, IL 62454

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

1101 N Allen St
Robinson, IL 62454
Phone (618) 544-3125

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1013579820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 E 1050TH AVE",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624492409",
            "telephone_number": "618-592-3119",
            "fax_number": "618-546-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 E 1050TH AVE",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624492409",
            "telephone_number": "618-592-3119",
            "fax_number": "618-546-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "HOLLY",
        "middle_name": "E",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.019582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "crawfordmh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 N Allen St",
            "city": "Robinson",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624541114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holly.harmon@crawfordmh.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1366 E 1050th Ave",
            "city": "Oblong",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624492409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oblong, IL

Sources for this page

Verify at the official NPI Registry.