Individual provider Active NPI

Emily Hatch Hollaway, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1053734681
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2316 Issued in OK
Practice address
9716 Riverside Pkwy Ste 100
Tulsa, OK 74137-7450
Phone
(918) 299-4333
NPI assigned
Feb 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2316 OK Primary

Addresses

Primary practice location

9716 Riverside Pkwy Ste 100
Tulsa, OK 74137-7450

Mailing address

9126 S Braden PL
Tulsa, OK 74137-4030
Phone (918) 521-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20140509000642 OK Practitioner - Physician Assistant 0547493900 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2316OKMDPhysician Assistant

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": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1053734681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9126 S BRADEN PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374030",
            "telephone_number": "918-521-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9716 RIVERSIDE PKWY STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377450",
            "telephone_number": "918-299-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAWAY",
        "first_name": "EMILY",
        "middle_name": "HATCH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.