Individual provider Active NPI

Marcia McDonnell Holstad, DSN, RN, C, FNP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1063462539
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN048542 Issued in GA
Practice address
341 Ponce de Leon Ave
Atlanta, GA 30308
Phone
(404) 616-9824
NPI assigned
May 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN048542 GA Primary

Addresses

Primary practice location

341 Ponce de Leon Ave
Atlanta, GA 30308

Mailing address

3020 Boles Farm LN
Duluth, GA 30096-5440
Phone (770) 622-9202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070925000531 GA Practitioner - Nurse Practitioner 1254425978 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN048542GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince May 1, 2010 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 1, 2010 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

341 Ponce de Leon Ave NE
Atlanta, GA 30308
Phone (404) 616-2440

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063462539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BOLES FARM LN",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965440",
            "telephone_number": "770-622-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 PONCE DE LEON AVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-616-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSTAD",
        "first_name": "MARCIA",
        "middle_name": "MCDONNELL",
        "name_prefix": "Ms.",
        "credential": "DSN, RN, C, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN048542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.