Individual provider Active NPI

Tana Diane Holloway, FNP

  • Family Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1154309342
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
205739 Issued in NC
Practice address
327 1St Ave NW
Hickory, NC 28601-6122
Phone
(828) 695-5900
Fax
(828) 695-4256
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 205739 NC Primary

Addresses

Primary practice location

327 1St Ave NW
Hickory, NC 28601-6122

Mailing address

113 Manor Circle
Mooresville, NC 28115
Phone (713) 294-7130

Other practice location 1

110 Charleston Dr
Unit 109
Mooresville, NC 28117-7700
Phone (704) 696-8182

Other identifiers 1

IdentifierTypeStateIssuer
363LF0000XOtherNCTAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205739NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Eneregtics PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154309342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MANOR CIRCLE",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28115",
            "telephone_number": "713-294-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 1ST AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286016122",
            "telephone_number": "828-695-5900",
            "fax_number": "828-695-4256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Charleston Dr",
            "address_2": "Unit 109",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281177700",
            "country_code": "US",
            "telephone_number": "704-696-8182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "TANA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "205739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "363LF0000X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.