Samuel Hollingsworth, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01032077 Issued in IN

Practice address

1801 N Senate Blvd
Ste 400
Indianapolis, IN 46202-1245

Phone

(317) 962-5581

Fax

(317) 962-5859

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Methodist Medical Group Physicians Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1285673616
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1053354043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N MERIDIAN ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043908",
            "telephone_number": "317-962-4941",
            "fax_number": "317-962-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD",
            "address_2": "STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021245",
            "telephone_number": "317-962-5581",
            "fax_number": "317-962-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01032077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100236860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Hollinger-Sieferman
• Erin Hollingshead, AGACNP
• Emma Hollingsworth, M.D.
• Jason Hollingsworth, MD
• Keona Hollingsworth
• Lamont S Hollins
• Ella Hollis, MSW
• Kara Michelle Hollis, RN
• Sierra Hollister, PHARMD
• Denise S Hollman, LCSW

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.