Individual provider Active NPI

Holly L Knowles, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1073549044
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004732 Issued in MI
Practice address
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone
(231) 672-3883
Fax
(231) 672-3973
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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 5601004732 MI Primary

Addresses

Primary practice location

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 727-5211

Other identifiers 1

IdentifierTypeStateIssuer
N34010018OtherMIMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060710000253 MI Practitioner - Physician Assistant 5698788800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Specialty ServicesGroup PAC ID 2365439544, 87 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-3883

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.08
Improvement activities
40
Cost
74.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004732MIMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1073549044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-5211",
            "fax_number": "231-727-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-672-3883",
            "fax_number": "231-672-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "N34010018",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.