Individual provider Active NPI

Holly Davison, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1104181874
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07928 Issued in TX
Practice address
1600 W 38TH St Ste 308
Austin, TX 78731-6406
Phone
(512) 324-3540
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 PA07928 TX Primary

Addresses

Primary practice location

1600 W 38TH St Ste 308
Austin, TX 78731-6406

Mailing address

1600 W 38TH St Ste 308
Austin, TX 78731-6406
Phone (512) 324-3540

Other identifiers 2

IdentifierTypeStateIssuer
314244001MedicaidTX
314244002MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120820000307 TX Practitioner - Physician Assistant 8426204892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

6001 Kyle Pkwy
Kyle, TX 78640-6112
Phone (512) 504-5000

Hospital & facility affiliations

  • Ascension Seton Hays Hospital, Kyle, TX, CCN 670056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07928TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Nov 19, 2012 Accepting new patients
Seton Family of Doctors CurrentSince Nov 19, 2012 Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1600 W 38th St
Ste 308
Austin, TX 78731

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Organizations & group practices 3

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": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1104181874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST STE 308",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316406",
            "telephone_number": "512-324-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST STE 308",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316406",
            "telephone_number": "512-324-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "HOLLY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314244001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314244002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.