Active NPI
Topaz Jerilyn Holloway, AGPCNP
- Adult Health Nurse Practitioner
- Clio, MI
National Provider Identifier
1194151993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 4704257322
- Practice address
- 4154 W Vienna Rd
Clio, MI 48420-2809 - Phone
- (810) 687-1008
- NPI assigned
- Sep 25, 2013
- Last updated
- Dec 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| 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 | Primary |
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
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- 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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704257322 | MI | MD | Gerontology 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 A
Okemos, MI 48864
Phone (517) 347-4085
2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085
Interoperability endpoints
- topaz.holloway.1@32913.direct.athenahealth.com
Organizations & group practices 3
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 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CenterWell Home Health
- Home Health Agency
- Flint, MI
- NPI 1114959483
-
dba Elara Caring
- Home Health Agency
- Jackson, MI
- NPI 1588642110
-
dba Alpine Care Home Health
- Home Health Agency
- Troy, MI
- NPI 1477544823
-
- Home Health Agency
- Lapeer, MI
- NPI 1316054810
-
- Community Based Hospice Care Agency
- Lapeer, MI
- NPI 1831395243
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701820800000",
"number": "1194151993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 639295 DEPT 93394",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452639295",
"telephone_number": "248-266-4200",
"fax_number": "855-618-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4154 W VIENNA RD",
"city": "CLIO",
"state": "MI",
"postal_code": "484202809",
"telephone_number": "810-687-1008"
}
],
"practiceLocations": [
{
"address_1": "4444 W Bristol Rd Ste 150",
"address_purpose": "LOCATION",
"city": "Flint",
"state": "MI",
"postal_code": "485073161",
"country_code": "US",
"telephone_number": "810-230-9500",
"fax_number": "810-230-0169",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "TOPAZ",
"middle_name": "JERILYN",
"name_prefix": "Dr.",
"credential": "AGPCNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-25",
"last_updated": "2023-12-06",
"certification_date": "2023-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MI",
"license": "4704257322",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MI",
"license": "4704257322",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704257322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clio, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.