Katelyn C Holloway, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

095411 Issued in IA

Practice address

800 Mercy Dr
Council Bluffs, IA 51503-3128

Phone

(855) 524-4001

Fax

(712) 325-2499

NPI assigned

Feb 26, 2019

Last updated

Jul 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE, WY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Health Physicians West LLCGroup PAC ID 5092978866, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Torrington, WY, CCN 531307

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Casper, WY
  • NPI 1063778728
  Medicare reassignment Care Compare group
• Regional West Physicians Clinic

  • Family Medicine Physician
  • Scottsbluff, NE
  • NPI 1306910534

  Physician Assistant

  Medicare reassignment NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment
• Community Hospital

  • Critical Access Hospital
  • Torrington, WY
  • NPI 1669410643
  Medicare reassignment
• Summit Hospitalist Group LLC

  • Hospitalist Physician
  • Cheyenne, WY
  • NPI 1356985600
  Medicare reassignment
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  NPD
• Community Hospital

  • Multi-Specialty Clinic/Center
  • Torrington, WY
  • NPI 1164950036
  NPD
• Community Hospital

  • Rural Health Clinic/Center
  • Torrington, WY
  • NPI 1174059786
  NPD
• Regional West Physicians Clinic

  • Rural Health Clinic/Center
  • Mitchell, NE
  • NPI 1992703425
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Hospital

  • Critical Access Hospital
  • Torrington, WY
  • NPI 1669410643
  Care Compare affiliation

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1427515402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "855-524-4001",
            "fax_number": "712-325-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "855-524-4001",
            "fax_number": "712-325-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KATELYN",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "095411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Hodapp, DPT
• Alexis Catharine Hofker, PLMHP, LMHC
• Taralyn Hoflen, PA-C
• Christopher J Holewinski, RP, DO
• Adam Burke Holland
• Alexis Rose Holmes
• Thomas William Homan, PA-C
• Hometown Inclusive Living LLC (Hometown Inclusive Living)
• Diana Elizabeth Hoogestraat, MSW/LISW
• Lauren Elizabeth Hoover, TLMHC

• Physician Assistant in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.