Holly Austin, PA-C
Individual provider Active NPI Physician Assistant · Clarksville, TN
NPI 1437403144 · NPPES record last updated Jan 23, 2019
Key facts
- NPI
- 1437403144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2252 (TN)
- Practice address
- 651 Dunlop LN
Clarksville, TN 37040-5015 - Phone
- (931) 502-1370
- Fax
- (931) 502-1364
- NPI assigned
- Nov 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121210000329 | TN | Practitioner - Physician Assistant | 6204088743 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magpie Emergency Physicians PLLC | Physician Assistant | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2252 | TN | Yes |
Addresses
Primary practice location
651 Dunlop LN
Clarksville, TN 37040-5015
Mailing address
651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-1370
Other names
- Holly Bagwell
Other providers in Clarksville, TN
- Dedrea Attaway
- Meghan Catherine Augustine
- Taylor Michele Ausbrooks
- Austin Peay State University Boyd Health Services
- Austin Peay State University Diagnostic Laboratory
- Joshua David Austin
- Marcia Austin
- Tania Austin
- Autism Foundation of Tennessee
- Autism Therapy and Training, PLLC
All providers in Clarksville, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.