NPIMap

Individual provider Active NPI

Warren H Holley, M.D.

  • Cardiovascular Disease Physician
  • Northport, AL
National Provider Identifier
1194719567
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
13116 Issued in AL
Practice address
4401 Watermelon Rd
Northport, AL 35473-5197
Phone
(205) 343-2811
Fax
(205) 391-0900
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 13116 AL Primary

Addresses

Primary practice location

4401 Watermelon Rd
Northport, AL 35473-5197

Mailing address

4401 Watermelon Rd
Northport, AL 35473-5197
Phone (205) 343-2811

Other identifiers 5

IdentifierTypeStateIssuer
000089287MedicaidAL
209445OtherBLACK LUNG PROGRAM
06575268MedicaidMS
51089287OtherALBC/BS OF ALABAMA
060015749OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000028 AL Practitioner - Cardiovascular Disease (Cardiology) 8527254267 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of California, Davis School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Associates of West Alabama, PCGroup PAC ID 5193704351, 4 clinicians
The DCH Healthcare AuthorityGroup PAC ID 8123924248, 11 clinicians

Practice addresses (Care Compare)

4401 Watermelon Rd
Northport, AL 35473-5197
Phone (205) 343-2811

801 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7800

809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Healthcare Authority CurrentSince Feb 6, 2012 Accepting new patients
DCH Provider Services, LLC Current Accepting new patients
DCH Healthcare Authority Current Accepting new patients
DCH Provider Services, LLC CurrentSince Sep 1, 2024 Accepting new patients
West Alabama Palliative Care Service LLC Current Accepting new patients
The DCH Health Care Authority CurrentSince Feb 6, 2012 Accepting new patients

Locations

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

4401 Watermelon Rd
Northport, AL 35473
Phone (205) 343-2811

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

Networks

  • bcbs alabama network 01G0
  • bcbs alabama network 01B0
  • bcbs alabama network 01A0
  • bcbs alabama network 01H0
  • bcbs alabama network 01E0

Interoperability endpoints

  • Direct secure messaging: warren.holley@caowa.eclinicaldirectplus.com

Organizations & group practices 7

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 8

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1194719567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735197",
            "telephone_number": "205-343-2811",
            "fax_number": "205-391-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735197",
            "telephone_number": "205-343-2811",
            "fax_number": "205-391-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "WARREN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "13116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000089287",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG PROGRAM",
            "identifier": "209445",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06575268",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ALABAMA",
            "identifier": "51089287",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060015749",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.