NPIMap

Individual provider Active NPI

Holly Rogers Gaines, ANP

  • Adult Health Nurse Practitioner
  • Conway, AR
National Provider Identifier
1376979799
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A003851 Issued in AR
Practice address
5 Medical LN
Conway, AR 72034-4912
Phone
(501) 224-5200
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A003851 AR Primary

Addresses

Primary practice location

5 Medical LN
Conway, AR 72034-4912

Mailing address

PO Box 20430
White Hall, AR 71612-0430
Phone (501) 661-9191

Other practice location 1

501 Millwood Cir Ste F
Maumelle, AR 72113-6304
Phone (501) 224-5200

Other practice location 2

11219 Financial Centre Pkwy
Suite 210
Little Rock, AR 72211-3800
Phone (501) 661-9191

Other practice location 3

1310 W B St
Russellville, AR 72801-2802
Phone (501) 224-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160621000983 AR Practitioner - Nurse Practitioner 8325339419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sleep Partners LLC 2 clinicians

Practice addresses (Care Compare)

5 Medical LN
Suite Candd
Conway, AR 72034-4912
Phone (501) 224-5200

Hospital & facility affiliations

  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
  • St Vincent Medical Center/North Hospital, Sherwood, AR, CCN 040137
  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Partners LLC CurrentSince May 25, 2016 Accepting new patients
Sleep Partners LLC PastSince Aug 1, 2021 Accepting new patients
Sleep Management DME LLC PastSince May 1, 2022 Accepting new patients
Paul E. Wylie, M.D., P.a. Past Accepting new patients

Locations

5 Medical Ln
Conway, AR 72034

5 Medical Ln
Ste C
Conway, AR 72034
Phone 5012245200 ext. 302

5 Medical Ln
Ste Cd
Conway, AR 72034

501 Millwood Cir
Ste F
Maumelle, AR 72113
Phone 5012245200302

501 Millwood Cir
Maumelle, AR 72113

7500 Dollarway Rd
Ste 201
White Hall, AR 71602
Phone 5012245200106

Organizations & group practices 4

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 9

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1376979799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20430",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716120430",
            "telephone_number": "501-661-9191",
            "fax_number": "501-661-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344912",
            "telephone_number": "501-224-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Millwood Cir Ste F",
            "address_purpose": "LOCATION",
            "city": "Maumelle",
            "state": "AR",
            "postal_code": "721136304",
            "country_code": "US",
            "telephone_number": "501-224-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11219 Financial Centre Pkwy",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722113800",
            "country_code": "US",
            "telephone_number": "501-661-9191",
            "fax_number": "501-661-1991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 W B St",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012802",
            "country_code": "US",
            "telephone_number": "501-224-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "HOLLY",
        "middle_name": "ROGERS",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A003851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.