Individual provider Active NPI

Holly Ann Shoemaker, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • Griffin, GA
National Provider Identifier
1396376596
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206832 Issued in GA
Practice address
747 S Hill St
Griffin, GA 30224-4830
Phone
(770) 228-5407
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 206832 GA Primary

Addresses

Primary practice location

747 S Hill St
Griffin, GA 30224-4830

Mailing address

305 Whitfield BND
Zebulon, GA 30295-3584
Phone (770) 584-9121

Other names 1

  • Ms. Holly Ann Groves Former name

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
I20200526000898 GA Practitioner - Nurse Practitioner 7911328117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
206832GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Apr 14, 2020 Accepting new patients
Privia Medical Group of Georgia LLC Single Specialty CurrentSince Apr 14, 2020 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

747 S Hill St
Griffin, GA 30224
Phone (770) 228-5407

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: holly.shoemaker.1@8042.direct.athenahealth.com

Organizations & group practices 2

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": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1396376596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WHITFIELD BND",
            "city": "ZEBULON",
            "state": "GA",
            "postal_code": "302953584",
            "telephone_number": "770-584-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244830",
            "telephone_number": "770-228-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "206832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "GROVES",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.