William A Holley, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N004933 Issued in NY

Practice address

2162 Main St
Buffalo, NY 14214-2634

Phone

(716) 862-9957

Fax

(716) 834-5007

NPI assigned

Apr 10, 2006

Last updated

Feb 13, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Four Corners Primary Care Centers, Inc.Group PAC ID 1951497494, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Four Corners Primary Care Centers Inc

  dba Four Corners @ VPH

  • Federally Qualified Health Center (FQHC)
  • Norcross, GA
  • NPI 1265624548
  Medicare reassignment Care Compare group NPD
• Four Corners Primary Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lawrenceville, GA
  • NPI 1285325282
  NPD
• Southwestern Testing Service, Inc.

  • Vascular Sonography Radiologic Technologist
  • Williamsville, NY
  • NPI 1972611226
  NPD (past)
• Four Corners Primary Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lawrenceville, GA
  • NPI 1356682959
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1205899457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142634",
            "telephone_number": "716-862-9957",
            "fax_number": "716-834-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2162 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142634",
            "telephone_number": "716-862-9957",
            "fax_number": "716-834-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01256248",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000511309005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua J Holland, DO
• Walter B. Holland Jr., DDS
• Stanley Jack Hollander, LPN
• N Ann Hollenberg, D.P.M.
• Carolyn Holley, LPN
• Elizabeth Hollingdrake
• Kimberley Marie Hollis, PHD
• Jerome Joseph Holloway Sr.
• Nadia Holloway
• Nicole Holloway, LMHC

• Podiatrist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.

Verify at the official NPI Registry.