Carolyn Faircloth Holman, C.R.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1023686 Issued in AL

Practice address

24980 State St
PO Drawer 519
Elberta, AL 36530-2573

Phone

(251) 986-7301

Fax

(251) 986-5927

NPI assigned

Jan 20, 2006

Last updated

Feb 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Carolyn Elizabeth Faircloth Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elberta Clinic, PC

  • Family Medicine Physician
  • Elberta, AL
  • NPI 1588752844
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1407836802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24980 STATE ST",
            "address_2": "PO DRAWER 519",
            "city": "ELBERTA",
            "state": "AL",
            "postal_code": "365302573",
            "telephone_number": "251-986-7301",
            "fax_number": "251-986-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24980 STATE ST",
            "address_2": "PO DRAWER 519",
            "city": "ELBERTA",
            "state": "AL",
            "postal_code": "365302573",
            "telephone_number": "251-986-7301",
            "fax_number": "251-986-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "CAROLYN",
        "middle_name": "FAIRCLOTH",
        "credential": "C.R.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1023686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00051740",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "51051740",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00289187",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "FAIRCLOTH",
            "middle_name": "ELIZABETH",
            "credential": "C.R.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stalina Maureen Estrada
• Jessica Frank, RBT
• Tiffani Giles
• Heath Health and Wellness
• High Hopes, Inc
• Caden Horn
• Christy Welch Howell
• Terry A Kurtts, M.D.
• Richard Neville Leverett, D.M.D.
• Lucy Jo Matier, RBT

• Family Nurse Practitioner in Elberta, AL
• Providers in Elberta, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.