Robert M Holley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11422 Issued in WV

Practice address

2500 Jefferson Ave
PT Pleasant, WV 25550

Phone

(304) 675-1675

Fax

(304) 675-3713

NPI assigned

Sep 21, 2006

Sex

Male

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 5

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Point Pleasant Physician Billing Services

  • Multi-Specialty Clinic/Center
  • PT Pleasant, WV
  • NPI 1396798898
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1295834810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 JEFFERSON AVE",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "25550",
            "telephone_number": "304-675-1675",
            "fax_number": "304-675-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 JEFFERSON AVE",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "25550",
            "telephone_number": "304-675-1675",
            "fax_number": "304-675-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050184000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001720019",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV COMPENSATION",
            "identifier": "55060926800",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0730678",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "550609268",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Frazier
• George B Corn PLLC
• Jordan Harris
• Rachelle A Hill, CFNP
• Monte Hoffman
• Ismael Ortego Jamora, MD
• John F. Wiltz PLLC
• Kennerly Surgical PLLC
• Erin Kirk, M.A., ED.S
• Nancy Beth Lares, MD

• Family Medicine Physician in PT Pleasant, WV
• Providers in PT Pleasant, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.