Holly K Fanning, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60834 Issued in CA

Practice address

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Phone

(858) 554-7909

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  VA

  Medicare reassignment Care Compare group
• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1174990303
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD

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

• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780

  Hospital

  Care Compare affiliation
• HCA Health Services of Virginia Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1194762294

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Intensivist Services PC 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Medicare fee-for-service enrollment

Enrolled in VA

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

Physician Assistant

State licenses

Practice roles

Locations

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1104387448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371027",
            "telephone_number": "858-554-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "HOLLY",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023260",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA60834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monsita Josefa Faley, FNP
• Joshua Paul Fallentine, MD
• Lakeisha Nacoste Falwell, RN, BSN, NP
• Family First Home Care
• Kelly Chenkai Fan, M. D.
• Halimo Shukri Yusuf Farah
• Lamis Elkhalil Farah, ND
• Kayla Yasmin Farahbod, RPH
• Amir Faraji
• Neil J. Farber, MD

• All providers in La Jolla, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.
• 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.