Individual provider Active NPI

Holly Laue, NP-C

  • Nurse Practitioner
  • Sullivan, IN
National Provider Identifier
1255743076
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71004904A Issued in IN
Practice address
2200 N Section St
Sullivan, IN 47882-7523
Phone
(812) 268-4311
Fax
(812) 268-6809
NPI assigned
May 28, 2014
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71004904A IN Primary
Family Nurse Practitioner 363LF0000X 71004904A IN

Addresses

Primary practice location

2200 N Section St
Sullivan, IN 47882-7523

Mailing address

PO Box 10
Sullivan, IN 47882-0010
Phone (812) 268-4311

Other practice location 1

2418 16th St
Bedford, IN 47421-3049
Phone (812) 508-2418

Other practice location 2

1569 A St NE
Linton, IN 47441-1607
Phone (812) 846-3380

Other identifiers 2

IdentifierTypeStateIssuer
000000895639OtherINANTHEM
201234250MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address holly.laue.1@8793.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71004904AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FC Indiana, LLC Nurse Practitioner CurrentSince Sep 6, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 11, 2023 Accepting new patients
Sullivan County Community Hospital CurrentSince Jan 1, 2020 Accepting new patients
Sullivan County Community Hospital CurrentSince Jan 1, 2020 Accepting new patients
Sullivan County Community Hospital CurrentSince Oct 1, 2020 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 11, 2023 Accepting new patients
Sullivan Family Practice, LLC Current Accepting new patients
FC Indiana, LLC CurrentSince Sep 6, 2023 Accepting new patients
Regional Hospital Healthcare Partners LLC Past Accepting new patients
Mso Clinics, Inc. Past Accepting new patients

Locations

2418 16th St
Bedford, IN 47421
Phone (812) 278-3154

1317 N State St
Greenfield, IN 46140
Phone (317) 967-2167

4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510

1569 A St NE
Linton, IN 47441
Phone (812) 846-3380

2186 N Hospital Blvd
Ste 2
Sullivan, IN 47882
Phone (812) 268-3318

2200 N Section St
Sullivan, IN 47882
Phone (812) 268-6292

2200 N Section St
#A
Sullivan, IN 47882
Phone (812) 268-3318

2200 N Section St
Ste A
Sullivan, IN 47882
Phone (812) 268-6292

2200 N Section St
Ste B
Sullivan, IN 47882

2229 Mary Sherman Dr
Sullivan, IN 47882
Phone (812) 238-2100

211 US Highway 66 E
Tell City, IN 47586
Phone (812) 722-4380

Interoperability endpoints

  • Direct secure messaging: holly.laue.1@8793.direct.athenahealth.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1255743076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478820010",
            "telephone_number": "812-268-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N SECTION ST",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827523",
            "telephone_number": "812-268-4311",
            "fax_number": "812-268-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2418 16th St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474213049",
            "country_code": "US",
            "telephone_number": "812-508-2418",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1569 A St NE",
            "address_purpose": "LOCATION",
            "city": "Linton",
            "state": "IN",
            "postal_code": "474411607",
            "country_code": "US",
            "telephone_number": "812-846-3380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUE",
        "first_name": "HOLLY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004904A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004904A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000895639",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201234250",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holly.laue.1@8793.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AthenaHealthcare EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2200 N Section St Ste B",
            "city": "Sullivan",
            "state": "IN",
            "country_code": "US",
            "postal_code": "478827523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sullivan, IN

Sources for this page

Verify at the official NPI Registry.