Individual provider Active NPI

Holly Yeatts, NP

  • Acute Care Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1326073446
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP07594 Issued in OH
Practice address
2132 E 3Rd St
Dayton, OH 45403-1991
Phone
(937) 528-6850
Fax
(937) 528-6810
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP07594 OH Primary

Addresses

Primary practice location

2132 E 3Rd St
Dayton, OH 45403-1991

Mailing address

500 Kirts Blvd Ste 100
Troy, MI 48084-4135
Phone (248) 434-6169

Other practice location 1

3033 Kettering Blvd Ste 100
Moraine, OH 45439
Phone (937) 293-2133

Other identifiers 1

IdentifierTypeStateIssuer
2623316MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060925000326 OH Practitioner - Nurse Practitioner 3274538301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Medical IncGroup PAC ID 5890765481, 80 clinicians

Practice addresses (Care Compare)

740 Commerce Dr
Suite a
Perrysburg, OH 43551-5276
Phone 24852821166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP07594OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Inc Current Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Oct 31, 2021 Accepting new patients
Vpa PC Current Accepting new patients
Mobile Medical, Inc. CurrentSince May 26, 2023 Accepting new patients
Mobile Medical, Inc. CurrentSince May 26, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Oct 31, 2021 Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
Hospice of Southwest Ohio, Inc. PastSince Jan 22, 2022 Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1326073446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-434-6169",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 E 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454031991",
            "telephone_number": "937-528-6850",
            "fax_number": "937-528-6810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 Kettering Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Moraine",
            "state": "OH",
            "postal_code": "45439",
            "country_code": "US",
            "telephone_number": "937-293-2133",
            "fax_number": "855-252-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEATTS",
        "first_name": "HOLLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "NP07594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2623316",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.