Individual provider Active NPI

Kevin D Hollis, M.D.

  • Anesthesiology Physician
  • Greensboro, NC
National Provider Identifier
1306102389
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2015-02511 Issued in NC
Practice address
600 Green Valley Rd
Suite 304
Greensboro, NC 27408-7700
Phone
(336) 282-4840
NPI assigned
Apr 4, 2012
Last updated
Aug 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2015-02511 NC Primary

Addresses

Primary practice location

600 Green Valley Rd
Suite 304
Greensboro, NC 27408-7700

Mailing address

600 Green Valley Rd
Suite 304
Greensboro, NC 27408-7700

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919000239 NC Practitioner - Anesthesiology 2860625878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants of North Carolina PLLCGroup PAC ID 7810256971, 24 clinicians

Practice addresses (Care Compare)

618 S Main St
Reidsville, NC 27320-5020
Phone (336) 951-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015-02511NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Consultants of North Carolina PLLC Anesthesiology CurrentSince Nov 1, 2017 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1306102389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 304",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 304",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087700",
            "telephone_number": "336-282-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2015-02511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.