Active NPI
Kristyn Joy Hollenback, PA-C
- Medical Physician Assistant
- Warrenton, VA
National Provider Identifier
1437588134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110004410
- Practice address
- 52 W Shirley Ave
Blue Ridge Orthopaedic Associates, P.C.
Warrenton, VA 20186-3008 - Phone
- (540) 347-9220
- Fax
- (540) 347-0492
- NPI assigned
- Nov 4, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110004410 | VA | Primary |
Addresses
Primary practice location
52 W Shirley Ave
Blue Ridge Orthopaedic Associates, P.C.
Warrenton, VA 20186-3008
Mailing address
52 W Shirley Ave
Blue Ridge Orthopaedic Associates, P.C.
Warrenton, VA 20186-3008
Phone (540) 347-9220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131216000536 | VA | Practitioner - Physician Assistant | 0042447278 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220
Hospital & facility affiliations
- Fauquier Hospital
- Uva Health Haymarket Medical Center
- Uva Health Culpeper Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110004410 | VA | MD | Medical Physician Assistant |
Interoperability endpoints
- khollenback514290@direct.healthsystem.virginia.edu
Organizations & group practices 1
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.
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1437588134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 W SHIRLEY AVE",
"address_2": "BLUE RIDGE ORTHOPAEDIC ASSOCIATES, P.C.",
"city": "WARRENTON",
"state": "VA",
"postal_code": "201863008",
"telephone_number": "540-347-9220",
"fax_number": "540-347-0492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 W SHIRLEY AVE",
"address_2": "BLUE RIDGE ORTHOPAEDIC ASSOCIATES, P.C.",
"city": "WARRENTON",
"state": "VA",
"postal_code": "201863008",
"telephone_number": "540-347-9220",
"fax_number": "540-347-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLENBACK",
"first_name": "KRISTYN",
"middle_name": "JOY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-04",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110004410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.