Amanda Holloway

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008361 Issued in GA

Practice address

150 Medical Way
Riverdale, GA 30274-2533

Phone

(404) 709-8373

NPI assigned

Feb 1, 2016

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 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

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.

• Positive Impact Health Centers Inc

  • Primary Care Clinic/Center
  • Duluth, GA
  • NPI 1790861995
  Medicare reassignment NPD
• Positive Impact Health Centers, Inc.

  • Community/Retail Pharmacy
  • Decatur, GA
  • NPI 1912476466
  NPD

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1114385598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MEDICAL WAY",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742533",
            "telephone_number": "404-709-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEDICAL WAY",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742533",
            "telephone_number": "404-709-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13678783",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malcolm Hill, D.C.
• Tahira Channel Hill
• Hillcrest Hospice, Inc.
• Hunter Hobgood
• Raven Sharmann Hodges
• Taina S. Holly, LPN
• Home Health Hospice
• Olivia Hood
• Hospital Ambulance of Georgia, LLC
• Kaitlyn Houck

• Professional Counselor in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.