Nathaniel Charles Hollister, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

73509 Issued in AZ

Practice address

5330 S Highway 95
Fort Mohave, AZ 86426-9225

Phone

(928) 788-2273

NPI assigned

Apr 10, 2021

Last updated

Jul 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment NPD
• Nes Arizona Inc

  • Emergency Medicine Physician
  • Benson, AZ
  • NPI 1205217700
  Medicare reassignment NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment NPD
• Nes Arizona Inc

  • Emergency Medicine Physician
  • Fort Mohave, AZ
  • NPI 1285163121
  NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919
  NPD

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1104406586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RANCHO LN STE 135",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063826",
            "telephone_number": "702-383-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S HIGHWAY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269225",
            "telephone_number": "928-788-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Rancho Ln Ste 135",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891063826",
            "country_code": "US",
            "telephone_number": "702-383-7885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLISTER",
        "first_name": "NATHANIEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "73509",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polly A Hediger, DC
• Hematology Oncology Associates of North Jersey, LLC (Dr. Mohtaseb Cancer Center and Blood Disorders)
• Richard E Hendrix, MD
• Larry Coomer Hernandez, PTA
• Cara Michelle Hetrick, RN, BSN
• Les Jay Holub, RPH
• Cari Dawn Horne, CSFA
• HPH Homecare, LLC
• Han-Chin C Huang, FNP
• Deborah Ann Hughson, RNP

• Emergency Medicine Physician in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.