Individual provider Active NPI

Terri L Hollis, DO

  • Hospitalist Physician
  • Havertown, PA
National Provider Identifier
1366600751
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OS014429 Issued in PA
Practice address
2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone
(610) 536-2100
Fax
(610) 536-2400
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS014429 PA
Hospitalist Physician 208M00000X OS014429 PA Primary

Addresses

Primary practice location

2000 Old West Chester Pike
Havertown, PA 19083-2712

Mailing address

2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone (610) 536-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080909000705 PA Practitioner - HospitalistPractitioner - Internal Medicine 7113093535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

2000 Old W Chester Pike
Havertown, PA 19083-2712
Phone (484) 337-4097

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS014429PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC Hospitalist Current Accepting new patients
Main Line Healthcare Internal Medicine CurrentSince May 1, 2011 Accepting new patients
Kindred Hospitals East, LLC Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2000 Old West Chester Pike
Havertown, PA 19083
Phone (610) 536-2100

6129 Palmetto St
Philadelphia, PA 19111
Phone (215) 722-8555

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1366600751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OLD WEST CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-536-2100",
            "fax_number": "610-536-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OLD WEST CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-536-2100",
            "fax_number": "610-536-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "TERRI",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS014429",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS014429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.