Topaz Jerilyn Holloway, AGPCNP
Individual provider Active NPI Adult Health Nurse Practitioner · Clio, MI
NPI 1194151993 · NPPES record last updated Dec 6, 2023
Key facts
- NPI
- 1194151993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 4704257322 (MI)
- Practice address
- 4154 W Vienna Rd
Clio, MI 48420-2809 - Phone
- (810) 687-1008
- NPI assigned
- Sep 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 21
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Michigan Medical School, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Vpa PC
Practice addresses (Care Compare)
Okemos, MI 48864
Phone (517) 347-4085
4444 W Bristol Rd
Suite 330
Flint, MI 48507-3159
Phone (810) 230-9500
Hospital & facility affiliations
- Elara Caring
- Alpine Care Home Health
- Residential Home Health and Hospice
- Centerwell Home Health
- Elara Caring
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20141009001102 | MI | Practitioner - Nurse Practitioner | 8628298932 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704257322 | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa PC | Current | Accepting new patients | |
| Vpa PC | Current |
Accepting new patients | |
| Vpa PC | Current |
Accepting new patients |
Locations
4444 W Bristol Rd
Ste 150
Flint, MI 48507
Phone (810) 230-9500
2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085
2205 Jolly Rd
Ste A
Okemos, MI 48864
Phone (517) 347-4085
Interoperability endpoints
- topaz.holloway.1@32913.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 4704257322 | MI | |
| Primary Care Nurse Practitioner | 363LP2300X | 4704257322 | MI | |
| Adult Health Nurse Practitioner | 363LA2200X | 4704257322 | MI | Yes |
Addresses
Primary practice location
4154 W Vienna Rd
Clio, MI 48420-2809
Mailing address
PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (248) 266-4200
Other practice location 1
4444 W Bristol Rd Ste 150
Flint, MI 48507-3161
Phone (810) 230-9500
Other providers in Clio, MI
- Haley Cristina Hart
- Karen Hassell
- Linda Lee Haven
- Michelle Louise Hermann
- High Quality Health Care
- Diane Kay Holmes
- Danielle Marie Holt
- Hometown Provider LLC
- Hope Shores Linden, LLC
- Ashley Lynn Hopkins
All providers in Clio, MI · Adult Health Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 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.