Holly Berryman Backe, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-139307 Issued in AL

Practice address

1216 Somerville Rd SE
Decatur, AL 35601-4335

Phone

(256) 340-0012

Fax

(256) 340-1408

NPI assigned

Feb 19, 2020

Sex

Female

Sole proprietor

Yes

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.

• Nephrology of North Alabama P.C.

  • Nephrology Physician
  • Decatur, AL
  • NPI 1417981622

  AL

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• H H Health System-Morgan LLC

  • General Acute Care Hospital
  • Decatur, AL
  • NPI 1356692297

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology of North Alabama P.C. 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: holly.backe@nona.eclinicaldirectplus.com

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1275166175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 DOGWOOD LN SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015317",
            "telephone_number": "256-476-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014335",
            "telephone_number": "256-340-0012",
            "fax_number": "256-340-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKE",
        "first_name": "HOLLY",
        "middle_name": "BERRYMAN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-139307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilatra Awoniyi, D.D.S.
• Wilnelsia A Awoniyi, DPM
• Jonathan S Aycock, DO
• Ellen L. Ayers, L.P.C.
• David S Bachman, DC
• Joseph Thomas Backe, MD
• Bailey Gammill LPC, LLC
• Joe David Bailey, BS
• Suzanna F Bailey, SLP
• Brenda Ann Baird, LPC

• All providers in Decatur, AL
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.