Active NPI
Ronnita Evette Holden, PA-C
- Physician Assistant
- Fort Liberty, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-00759
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| C5-0000456 | DE | MD | Physician Assistant |
| C0002942 | MD | MD | Physician Assistant |
| 0110001887 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiatry Consultants of NC PLLC | Current | Accepting new patients | |
| North Carolina Center for Weight Management | Physician Assistant | Past | 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.
-
- Physical Medicine & Rehabilitation Physician
- Morton Grove, IL
- NPI 1437736881
NC
-
- Physician Assistant
- Cameron, NC
- NPI 1134695026
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.