Jennifer Samples Holl, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

103860 Issued in GA

Practice address

5667 Peachtree Dunwoody Rd
Atlanta, GA 30342-1725

Phone

(404) 252-5669

Fax

(404) 252-9473

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jennifer Elizabeth Samples Former name

Medicare fee-for-service enrollment

Enrolled in NC, FL, GA3 enrollments

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 3

Specialty

Colorectal Surgery (Proctology)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment NPD
• Surgical Specialists of Charlotte, P.a.

  • Surgery Physician
  • Charlotte, NC
  • NPI 1073599734
  Medicare reassignment
• Atlanta Colon and Rectal Surgery, PA

  • Colon & Rectal Surgery Physician
  • Atlanta, GA
  • NPI 1356382865
  NPD (past)

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1336460922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-252-5669",
            "fax_number": "404-252-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-252-5669",
            "fax_number": "404-252-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLL",
        "first_name": "JENNIFER",
        "middle_name": "SAMPLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME162888",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "103860",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2018-01719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336460922",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SAMPLES",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holistic Haven Counseling LLC
• Holistic Health and Community Services Inc
• Holistic Occupational and Physical Therapy LLC
• Holistic Therapeutic Counseling, LLC
• Holisticare South LLC
• Nadya Hollahan, PH.D.
• Antoinette Holland, MD
• Brantley Davison Holland
• Brittany Holland, LMSW
• David Preston Holland, MD, MHS

• Colon & Rectal Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Colon & Rectal Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.