Individual provider Active NPI

Holly G Danneman, MD

  • Family Medicine Physician
  • Edgewood, KY
National Provider Identifier
1417958349
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37311 Issued in KY
Practice address
413 S Loop Rd
Edgewood, KY 41017-5446
Phone
(859) 301-3800
Fax
(859) 301-3820
NPI assigned
Aug 2, 2005
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37311 KY
Family Medicine Physician 207Q00000X 37311 KY Primary
Hospitalist Physician 208M00000X 37311 KY

Addresses

Primary practice location

413 S Loop Rd
Edgewood, KY 41017-5446

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-3800

Other practice location 1

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

Other identifiers 3

IdentifierTypeStateIssuer
2527144MedicaidOH
64078512MedicaidKY
200533890MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040304000710 KY Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Hospitalist 6305733197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

413 S Loop Rd
Edgewood, KY 41017-5446
Phone (859) 301-3800

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37311KYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Summit Medical Group, Inc Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
St Elizabeth Medical Center, Inc Emergency Medicine Current Accepting new patients
Family Care of Northern Kentucky, PLLC Past Accepting new patients
Family Care of Northern Kentucky, PLLC Family Medicine Past Accepting new patients

Locations

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

401 E 20th St
Covington, KY 41014
Phone (859) 283-6600

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1417958349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANNEMAN",
        "first_name": "HOLLY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "37311",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "37311",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "37311",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2527144",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64078512",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200533890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.