Individual provider Active NPI

Jaimie N Hollis, NP

  • Critical Care Medicine Nurse Practitioner
  • Athens, GA
National Provider Identifier
1023724986
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
RN283347 Issued in GA
Practice address
1199 Prince Ave
Athens, GA 30606-2797
Phone
(706) 475-7000
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X RN283347 GA
Trauma Surgery Physician 2086S0127X RN283347 GA
Critical Care Medicine Nurse Practitioner 363LC0200X RN283347 GA Primary

Addresses

Primary practice location

1199 Prince Ave
Athens, GA 30606-2797

Mailing address

1257 Four Lakes Dr
Madison, GA 30650-4267
Phone (478) 457-4211

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230613003113 GA Practitioner - Nurse Practitioner 0840657433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Hospitalist Physicians LLCGroup PAC ID 6305196411, 174 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-5076

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Merit-based Incentive Payment System (MIPS)

Final score
88.71 of 100Reported as group
Quality
73.45
Promoting interoperability
100
Improvement activities
40
Cost
80.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN283347GAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Jul 1, 2024 Accepting new patients
Athens Pulmonary and Allergy, P.C. Pulmonary Disease CurrentSince May 10, 2023 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

3320 Old Jefferson Rd
Ste 200A
Athens, GA 30607
Phone (706) 549-5560

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1023724986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 FOUR LAKES DR",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504267",
            "telephone_number": "478-457-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062797",
            "telephone_number": "706-475-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "JAIMIE",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "RN283347",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "GA",
            "license": "RN283347",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "GA",
            "license": "RN283347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.