Holly Marie Short, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5012132 Issued in NC

Practice address

2400 N Main St
Fuquay Varina, NC 27526-8573

Phone

(919) 235-6499

NPI assigned

Aug 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Holly Marie Kowanick Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Raleigh Neurosurgical Clinic IncGroup PAC ID 1759315500, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hshort243651@directhisp.wakemed.org

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.

• Raleigh Neurosurgical Clinic, Inc.

  • Neurological Surgery Physician
  • Raleigh, NC
  • NPI 1598702490
  Medicare reassignment Care Compare group NPD
• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC, Nurse Practitioner

  Medicare reassignment NPD
• Raleigh Neurosurgical Clinic, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Goldsboro, NC
  • NPI 1801660212
  NPD
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Fuquay Varina, NC
  • NPI 1497526719
  NPD
• Wake Specialty Physicians LLC

  • Pediatrics Physician
  • Fuquay Varina, NC
  • NPI 1578334892
  NPD

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

• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1285280313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268573",
            "telephone_number": "919-235-6499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5838 Six Forks Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276093893",
            "country_code": "US",
            "telephone_number": "919-785-3400",
            "fax_number": "919-783-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORT",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012132",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285280313",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "KOWANICK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Preeya Tushar Shah, MD
• Lauryn Shepard
• Eun Seon Shim
• Shining Stars Therapy, PA
• Shining Stars Therapy, PA
• Melissa Mary Sidella, PTA
• Allison T. Siebern, PH.D.
• Emily Lait Silva, MS, CCC-SLP
• Markaya Simkin
• Pawandip K Singh, DMD

• Family Nurse Practitioner in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.