Individual provider Active NPI

Kayla Melissa Holloway, NP-C

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1275909426
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN211441 Issued in GA
Practice address
610 3Rd St
Macon, GA 31201-3294
Phone
(478) 464-2600
Fax
(478) 724-2040
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN211441 GA Primary

Addresses

Primary practice location

610 3Rd St
Macon, GA 31201-3294

Mailing address

610 3Rd St
Macon, GA 31201-3294
Phone (478) 464-2600

Other names 1

  • Kayla Melissa Blount Former name

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125000737 GA Practitioner - Nurse Practitioner 1153621032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Central Ga LLCGroup PAC ID 6901702059, 17 clinicians

Practice addresses (Care Compare)

610 3Rd St
Macon, GA 31201-3262
Phone (478) 464-2600

6103 Rd St
Suite 202
Macon, GA 31201-3262
Phone (478) 464-2600

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Central Ga, LLC CurrentSince Sep 28, 2015 Accepting new patients
Synergetic Healings LLC Past Accepting new patients

Locations

610 3rd St
Ste 202
Macon, GA 31201
Phone (478) 216-7378

610 3rd St
Ste 206
Macon, GA 31201

610 3rd St
Ste 204
Macon, GA 31201
Phone (478) 477-3936

610 3rd St
Ste 100
Macon, GA 31201
Phone (478) 745-8205

610 3rd St
Macon, GA 31201

Interoperability endpoints

  • Direct secure messaging: kayla.blount@gaocg.eclinicaldirectplus.com

Organizations & group practices 2

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 3

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1275909426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 3RD ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013294",
            "telephone_number": "478-464-2600",
            "fax_number": "478-724-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 3RD ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013294",
            "telephone_number": "478-464-2600",
            "fax_number": "478-724-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KAYLA",
        "middle_name": "MELISSA",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN211441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "BLOUNT",
            "middle_name": "MELISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.