Individual provider Active NPI

Holly K Willyard, CNP

  • Family Nurse Practitioner
  • Lovington, NM
National Provider Identifier
1386777878
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP00494 Issued in NM
Practice address
605 West Taylor
Lovington, NM 88260
Phone
(575) 739-0062
Fax
(575) 396-1454
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R26153 NM
Family Nurse Practitioner 363LF0000X CNP00494 NM Primary

Addresses

Primary practice location

605 West Taylor
Lovington, NM 88260

Mailing address

1600 North Main
Lovington, NM 88260-2830
Phone (575) 396-6611

Other identifiers 2

IdentifierTypeStateIssuer
99177528MedicaidNM
515063YNGGOtherNMPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20070822000486 NM Practitioner - Nurse Practitioner 1355433301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nor-Lea Hospital DistrictGroup PAC ID 2466364534, 58 clinicians

Practice addresses (Care Compare)

1600 N Main
Lovington, NM 88260-2813

1600 N Main Ave
Lovington, NM 88260-2813
Phone 57539666115303

Hospital & facility affiliations

  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R26153NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nor-Lea Hospital District CurrentSince Sep 10, 2013 Accepting new patients
Nor-Lea Hospital District CurrentSince Sep 10, 2013 Accepting new patients
Nor-Lea Hospital District Past Accepting new patients
Southeastern Plains Emergency Physicians, LLC Past Accepting new patients

Locations

515 E Main St
Hobbs, NM 88240
Phone (575) 397-0560

1600 N Main Ave
Lovington, NM 88260
Phone (575) 396-6611

Interoperability endpoints

  • Direct secure messaging: hwillyard1266615@oc.providencedirect.org

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 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1386777878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NORTH MAIN",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602830",
            "telephone_number": "575-396-6611",
            "fax_number": "575-396-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WEST TAYLOR",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "88260",
            "telephone_number": "575-739-0062",
            "fax_number": "575-396-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLYARD",
        "first_name": "HOLLY",
        "middle_name": "K",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R26153",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99177528",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "515063YNGG",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovington, NM

Sources for this page

Verify at the official NPI Registry.