Lori B Holladay, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · MC Kenzie, TN
NPI 1144644246 · NPPES record last updated Feb 2, 2023
Key facts
- NPI
- 1144644246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN18359 (TN)
- Practice address
- 205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649 - Phone
- (731) 352-7907
- Fax
- (731) 352-4459
- NPI assigned
- Feb 10, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baptist Memorial Hospital-Huntingdon
Practice addresses (Care Compare)
631 RB Wilson Dr
Huntingdon, TN 38344-1727
Phone (731) 986-4481
641 RB Wilson Dr
Huntingdon, TN 38344-1733
Phone (731) 986-4461
Hospital & facility affiliations
- Baptist Memorial Hospital - Carroll County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140506001191 | TN | Practitioner - Nurse Practitioner | 8224261896 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN18359 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Memorial Hospital-Huntingdon | Current |
Accepting new patients | |
| Baptist Memorial Hospital-Huntingdon | Current |
Accepting new patients | |
| Baptist Memorial Hospital-Huntingdon | Past | Accepting new patients | |
| McKenzie Medical Center PC | Family | Past | Accepting new patients |
Locations
631 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-2933
641 Rb Wilson Dr
Ste G
Huntingdon, TN 38344
Phone (731) 986-7400
641 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-4461
205 Hospital Dr
Ste A
Mc Kenzie, TN 38201
Phone 7313527907 ext. 429
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN18359 | TN | Yes |
Addresses
Primary practice location
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Mailing address
965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q003306 | Medicaid | TN | |
| 3380640 | Other | TN | MEDICAID GROUP |
Other providers in MC Kenzie, TN
- Lacee Marie Harris
- Joyce R Hayes
- Brady Ray Heath
- Henry County Orthopaedic Surgery & Sports Medicine, PC
- John R Holancin
- David Matthew Holsinger
- Home Medical Products, Inc
- Laura Alessandra Horner
- Francis Howe
- Bruce Lee Ingmire
All providers in MC Kenzie, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.