Renee Dawn Holloway-Vaughan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

142993 Issued in GA

Practice address

1317 Antietam Dr
Columbus, GA 31907-6887

Phone

(706) 570-9541

NPI assigned

Aug 25, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1114530706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ANTIETAM DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319076887",
            "telephone_number": "706-570-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 ANTIETAM DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319076887",
            "telephone_number": "706-570-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY-VAUGHAN",
        "first_name": "RENEE",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "142993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Columbus",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Columbus",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Columbus",
            "address_1": "1317 Antietam Dr",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319076887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony Theodore Hollifield Jr., APRN
• Shakeitha Hollingsworth
• Jordan Hollins
• Yolanda Hollis
• Brianca J Holloman
• Christopher Holloway
• Jessica Holloway
• Jillian Holloway
• Tanya Renee Holloway
• Cynthia Holmes

• Family Nurse Practitioner in Columbus, GA
• Providers in Columbus, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.