Individual provider Active NPI

Ronnita Evette Holden, PA-C

  • Physician Assistant
  • Fort Liberty, NC
National Provider Identifier
1063487890
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00759 Issued in NC
Practice address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-9379
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00759 NC Primary
Physician Assistant 363A00000X C5-0000456 DE
Physician Assistant 363A00000X 0110001887 VA
Physician Assistant 363A00000X C0002942 MD

Addresses

Primary practice location

2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-9379

Mailing address

2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001

Other practice location 1

181 Mittie Haddock Dr
Cameron, NC 28326-9379
Phone (919) 842-5566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20141208000735 NC Practitioner - Physician Assistant 2466774104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Maryland School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiatry Consultants of NC PLLCGroup PAC ID 2567871643, 77 clinicians

Practice addresses (Care Compare)

2702 Farrell Rd
Sanford, NC 27330-6505
Phone (919) 776-9602

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0000456DEMDPhysician Assistant
C0002942MDMDPhysician Assistant
0110001887VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Consultants of NC PLLC CurrentSince Jan 1, 2026 Accepting new patients
North Carolina Center for Weight Management Physician Assistant PastSince Oct 1, 2022 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1 Pond St
Arden, NC 28704
Phone 82877452220027

2346 Barrington Cir
Fayetteville, NC 28303
Phone (704) 598-5031

523 Country Club Dr
Fayetteville, NC 28301
Phone (910) 488-0711

2702 Farrell Rd
Sanford, NC 27330
Phone (919) 608-9123

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1063487890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283109379",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Mittie Haddock Dr",
            "address_purpose": "LOCATION",
            "city": "Cameron",
            "state": "NC",
            "postal_code": "283269379",
            "country_code": "US",
            "telephone_number": "919-842-5566",
            "fax_number": "919-375-2048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "RONNITA",
        "middle_name": "EVETTE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00759",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000456",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001887",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Liberty, NC

Sources for this page

Verify at the official NPI Registry.