Jacqueline Holloway, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN188889 Issued in GA

Practice address

525 Cassidy Rd
Thomasville, GA 31792-4088

Phone

(229) 225-5076

NPI assigned

Jul 12, 2021

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1326610189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011706",
            "telephone_number": "229-376-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 CASSIDY RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924088",
            "telephone_number": "229-225-5076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 1/2 S Slappey Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317012616",
            "country_code": "US",
            "telephone_number": "229-473-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN188889",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN188889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamiko Hill, LCSW
• Margaret Fallin Hobbs, P.T.A.
• Shaun Hoenstine, M.D.
• Britini L Holder, MED CCC-SLP
• James Arthur Holland, M.D.
• Dylan Edward Holtman, DMD
• Hometown Homecare LLC
• Benjamin Honey, PA
• Deren H Hooks, P.A.-C.
• Michael A Hooks, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.