Charlotte Louise Von Holleben, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11028799 Issued in FL

Practice address

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607

Phone

(727) 725-6863

Fax

(727) 725-6734

NPI assigned

Sep 25, 2023

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 FL

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

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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Nurse Practitioner

  Medicare reassignment NPD
• Trustees of Mease Hospital, Inc

  • Family Medicine Physician
  • Safety Harbor, FL
  • NPI 1063204758
  Medicare reassignment NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1013796432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 GREYBROOKE PL",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346775115",
            "telephone_number": "727-412-4916",
            "fax_number": "727-785-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956607",
            "telephone_number": "727-725-6863",
            "fax_number": "727-725-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON HOLLEBEN",
        "first_name": "CHARLOTTE",
        "middle_name": "LOUISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11028799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Valladares, M.D.
• Randae Marie Vandenover, LMT
• Vilma M Vega, MD
• Angela Ventura
• Isabella Villegas
• Paulas Madhusudan Vyas, M.D.
• Rachel Waller
• Sabrina D Warner, LMHC
• Jennifer Evans Watson, DO
• Kemesha Watson

• Nurse Practitioner in Safety Harbor, FL
• Providers in Safety Harbor, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.