Holly Portillo, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP126462 Issued in TX

Practice address

894 US Highway 77
Rosebud, TX 76570

Phone

(254) 721-2563

Fax

(254) 583-7829

NPI assigned

Sep 19, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1578175865
  NPD

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1063814101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 US HIGHWAY 77",
            "city": "ROSEBUD",
            "state": "TX",
            "postal_code": "765703325",
            "telephone_number": "254-721-2563",
            "fax_number": "254-583-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 US HIGHWAY 77",
            "city": "ROSEBUD",
            "state": "TX",
            "postal_code": "76570",
            "telephone_number": "254-721-2563",
            "fax_number": "254-583-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "HOLLY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP126462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heritage House Nursing and Rehabilitation LP
• James L Hailey Jr
• Christine Marie Kidd
• Amanda Miller, RN
• Jinny Narula, M.D.
• Rosebud I Enterprises, LLC
• Sterling Health & Wellness
• Ruthann Marie Vorndran
• Wellness in the Golden Years, LLC

• Adult Health Nurse Practitioner in Rosebud, TX
• Providers in Rosebud, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.