Holly Jo Paul, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704169647 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 788-4996

Fax

(517) 796-6410

NPI assigned

May 12, 2006

Last updated

Nov 23, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Emergency Physicians PCGroup PAC ID 6709798325, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hpaul461804@direct.hfhs.org

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.

• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment Care Compare group NPD
• Iep - Post Acute Care PLLC

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1760166821
  Medicare reassignment NPD
• Iep Observation Medicine - Jackson PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jackson, MI
  • NPI 1982478251
  Medicare reassignment NPD
• Iep Urgent Care - Jackson PLLC

  • Urgent Care Clinic/Center
  • Jackson, MI
  • NPI 1336725688
  Medicare reassignment NPD
• Ihp Hospital Medicine - Jackson PLLC

  • Hospitalist Physician
  • Jackson, MI
  • NPI 1275306078
  Medicare reassignment NPD
• Independent Hospitalist Physicians, PLLC

  • Hospitalist Physician
  • Southfield, MI
  • NPI 1851820641
  Medicare reassignment NPD
• Independent Observation Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1700119500
  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD
• Center for Hematology-Oncology of S. Michigan

  • Hematology (Internal Medicine) Physician
  • Jackson, MI
  • NPI 1396833687
  NPD (past)
• Cogent Healthcare of Michigan PC

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1295047165

  Nurse Practitioner

  NPD (past)

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

• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1295786630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4996",
            "fax_number": "517-796-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "HOLLY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704169647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00322004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00371302",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4813065",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia L. Rooney, D.O.
• David A Patrick, DO
• Michael David Patrick, COTA
• Gregg Arthur Patten, MD
• Paul S Kenyon, MD PC
• Dalila Sharon Diane Payne
• Edwin Payne, LPC
• Kylie Payne
• Salina Payne
• Pdhcrc, Inc. (Potential Development Homes, Inc.)

• Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.