Individual provider Active NPI

Holly Noelle Hnetynka, PA-C

  • Physician Assistant
  • Shepherd, MI
National Provider Identifier
1114703634
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011982 Issued in MI
Practice address
322 E Wright Ave
Shepherd, MI 48883-9375
Phone
(989) 828-4614
NPI assigned
Sep 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011982 MI Primary

Addresses

Primary practice location

322 E Wright Ave
Shepherd, MI 48883-9375

Mailing address

322 E Wright Ave
Shepherd, MI 48883-9375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20231031001603 MI Practitioner - Physician Assistant 0749636538 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Central Michigan College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sparrow Carson HospitalGroup PAC ID 7113836701, 63 clinicians

Practice addresses (Care Compare)

102 S 3Rd St
Carson City, MI 48811-5115

245 S 2ND St
Carson City, MI 48811-9650

401 E Elm St
Carson City, MI 48811-8600
Phone (989) 584-6217

401 E Elm St
Carson City, MI 48811-9693
Phone (989) 584-6217

406 E Elm St
Carson City, MI 48811-0879
Phone (989) 584-6321

406 E Elm St
Carson City, MI 48811-9693

639 E Main St
Sparrow Medical Group OBGYN Carson
Carson City, MI 48811-9795
Phone (989) 584-3107

Sparrow Medical GRP Ear Nose Throat
Carson City, MI 48811-5115
Phone (989) 584-0932

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Aug 31, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Aug 31, 2024 Accepting new patients
Sparrow Clinton Hospital CurrentSince Aug 31, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Aug 31, 2024 Accepting new patients
Sparrow Clinton Hospital CurrentSince Aug 31, 2024 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Aug 31, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Aug 31, 2024 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

550 E Washington St
Fl 2
Ionia, MI 48846
Phone (616) 523-1600

1004 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-9790

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1114703634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488839375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488839375",
            "telephone_number": "989-828-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HNETYNKA",
        "first_name": "HOLLY",
        "middle_name": "NOELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherd, MI

Sources for this page

Verify at the official NPI Registry.