Individual provider Active NPI

Eddie Lee Hollowell, ACNP

  • Adult Health Nurse Practitioner
  • Buckeye, AZ
National Provider Identifier
1124875828
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
305274 Issued in AZ
Practice address
26700 S US Highway 85
Buckeye, AZ 85326-5024
Phone
(623) 386-6160
NPI assigned
May 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 305274 AZ Primary

Addresses

Primary practice location

26700 S US Highway 85
Buckeye, AZ 85326-5024

Mailing address

3099 N Lainey LN
Buckeye, AZ 85396-7328
Phone (602) 663-1672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250922001532 AZ Practitioner - Nurse Practitioner 4789188723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16772 W Bell Rd
Suite 110 619
Surprise, AZ 85374-3064

3099 N Lainey LN
Buckeye, AZ 85396-7328

Hospital & facility affiliations

  • Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
305274AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shirah Surgical PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

720 E Thunderbird Rd
Ste 3
Phoenix, AZ 85022
Phone (480) 531-1681

16772 W Bell Rd
Ste 110619
Surprise, AZ 85374
Phone (480) 466-0827

Organizations & group practices 1

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.

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": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1124875828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 N LAINEY LN",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853967328",
            "telephone_number": "602-663-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26700 S US HIGHWAY 85",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853265024",
            "telephone_number": "623-386-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWELL",
        "first_name": "EDDIE",
        "middle_name": "LEE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "305274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

Verify at the official NPI Registry.