Individual provider Active NPI

Audline Maria Holmes, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1336740398
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP236320 Issued in GA
Practice address
11111 Houze Rd Ste 225
Roswell, GA 30076-5618
Phone
(770) 603-0123
Fax
(770) 910-9919
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP236320 GA Primary
Registered Nurse 163W00000X RN236320 GA

Addresses

Primary practice location

11111 Houze Rd Ste 225
Roswell, GA 30076-5618

Mailing address

11111 Houze Rd Ste 225
Roswell, GA 30076-5618
Phone (770) 603-0123

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210429000542 GA Practitioner - Nurse Practitioner 5092124214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

11111 Houze Rd
Suite 225
Roswell, GA 30076-5618
Phone (770) 603-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN236320GAMDRegistered Nurse
APRN-NP236320GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Apr 22, 2021 Accepting new patients

Locations

11111 Houze Rd
Ste 225
Roswell, GA 30076
Phone (770) 436-9700

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.audlinehodnett@124220.advancedmd-direct.com

Organizations & group practices 1

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1336740398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 HOUZE RD STE 225",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765618",
            "telephone_number": "770-603-0123",
            "fax_number": "770-910-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 HOUZE RD STE 225",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765618",
            "telephone_number": "770-603-0123",
            "fax_number": "770-910-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "AUDLINE",
        "middle_name": "MARIA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP236320",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN236320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.