Capricia Renee Hollis

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

090710-1 Issued in NY

Practice address

2901 Campus Rd
Brooklyn, NY 11210-2153

Phone

(646) 659-2120

NPI assigned

May 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1295729408
  Medicare reassignment NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1356871081
  NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1972877017
  NPD

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1265960934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CAMPUS RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102153",
            "telephone_number": "646-659-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CAMPUS RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102153",
            "telephone_number": "646-659-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "CAPRICIA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090710-1",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "090710-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252Y00000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Hollingsworth
• Jessica Hollingsworth
• Sheila Hollingsworth, LMSW
• Charise Hollins-Lovemore
• Nathalee Hollinshead, LCSW
• Darien Holloman, CASAC
• Joy S Holloway-D'Avilar
• Danielle S Holloway-St Arromand, LCSW
• Abena Abiola Holloway, FNP
• Langdon L Holloway, LCSW, CASAC, LCADC

• Early Intervention Provider Agency in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.