Holly Ann Wolters, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003461 Issued in OH

Practice address

4160 Little York Rd
Suite 10
Dayton, OH 45414-5800

Phone

(937) 415-9100

Fax

(937) 415-9191

NPI assigned

Jan 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Holly Ann Fortkamp Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Associates of SW Ohio IncGroup PAC ID 9638258874, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne Hospital Hospital, Greenville, OH, CCN 361335

Merit-based Incentive Payment System (MIPS)

Final score

83.43 of 100Reported as group

Quality

70.97

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: holly.wolters@oaswo.eclinicaldirectplus.com

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.

• Orthopedic Associates of SW Ohio, Inc

  • Orthopaedic Surgery Physician
  • Dayton, OH
  • NPI 1447422118
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Wayne Hospital Company

  • Critical Access Hospital
  • Greenville, OH
  • NPI 1184621161
  Care Compare affiliation

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1104197318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713130",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452710001",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "SUITE 10",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145800",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERS",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01170703",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071994",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "FORTKAMP",
            "middle_name": "ANN",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Wolhandler
• Judith E Woll, M.D.
• Kathleen Marie Wolner, MD
• Anna Wolowicz
• Brandon Wolters
• Nick Wolters
• Jon Lieth Woltmann Jr., MD
• Titus Y Wolverton, D.C.
• Womack Army Medical Center
• Womack Dayton Pediatric Dentistry Inc

• Physician Assistant in Dayton, OH
• Providers in Dayton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.

Verify at the official NPI Registry.