Holly Johnson LTC, PLLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP136353 Issued in TX

Legal business name

HOLLY JOHNSON LTC, PLLC

Practice address

5505 New Copeland Rd
Tyler, TX 75703-3955

Phone

(903) 705-0202

NPI assigned

Feb 9, 2018

Organization subpart

No

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

Authorized official

Name

Holly M Augustus, FNP-C

Title

Owner/Employee

Phone

(903) 721-0865

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1114426756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 MONROE ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664342",
            "telephone_number": "903-721-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033955",
            "telephone_number": "903-705-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY JOHNSON LTC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-09",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "AUGUSTUS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "903-721-0865",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP136353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Holleman
• Everett Dean Holley, MD
• Elizabeth Holloway, OTR
• Jennifer Lynn Holloway
• Jessica Holloway
• Jeanna Holly
• Jennifer Dykes Holman, MD
• Sequoia Sana' Holmes
• Tamra Marchelle Holmes, CSFA
• Thomas R Holmes, OTR

• Primary Care Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.