Maria Jane Holder, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN223280 Issued in GA

Practice address

2205 Riverstone Blvd Ste 205
Canton, GA 30114-5250

Phone

(770) 720-5011

Fax

(770) 345-1088

NPI assigned

Jun 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

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.

• Scott B. Parry, D.O.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1306860101
  Medicare reassignment
• Craig Wellness and Recovery

  • Addiction Medicine (Family Medicine) Physician
  • Canton, GA
  • NPI 1992671242
  NPD
• Intown Primary Care, PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1104262294
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1083064737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 RIVERSTONE BLVD STE 205",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145250",
            "telephone_number": "770-720-5011",
            "fax_number": "770-345-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 RIVERSTONE BLVD STE 205",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145250",
            "telephone_number": "770-720-5011",
            "fax_number": "770-345-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Cheshire Bridge Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303244234",
            "country_code": "US",
            "telephone_number": "404-541-0944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "OR",
            "postal_code": "974249700",
            "country_code": "US",
            "telephone_number": "541-767-5200",
            "fax_number": "541-767-5292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 Depot St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Ball Ground",
            "state": "GA",
            "postal_code": "301074065",
            "country_code": "US",
            "telephone_number": "678-648-1756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "MARIA",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN223280",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "2001708004NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN223280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Delaney Hinkle, RN
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• Diane L Hollander, PSYD, BCBA-D
• Sandra Sue Hollingsworth, R.PH.
• Holly Springs Chiropractic Clinic, Inc.
• Holly Springs Pharmacy LLC
• Holly Springs Pharmacy LLC

• Psychiatric/Mental Health Nurse Practitioner in Canton, GA
• Providers in Canton, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.