Individual provider Active NPI

Laura Holliger, CNP

  • Primary Care Nurse Practitioner
  • North Canton, OH
National Provider Identifier
1437605409
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP019548 Issued in OH
Practice address
1441 S Main St
North Canton, OH 44720-4245
Phone
(330) 244-8888
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP019548 OH
Gerontology Nurse Practitioner 363LG0600X APRN.CNP019548 OH
Primary Care Nurse Practitioner 363LP2300X APRN.CNP019548 OH Primary

Addresses

Primary practice location

1441 S Main St
North Canton, OH 44720-4245

Mailing address

3128 Brumbaugh St NW
North Canton, OH 44720-7940
Phone (740) 262-2075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20180820001481 OH Practitioner - Nurse Practitioner 8527317882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP019548OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Town Park Physical Therapy & Wellness Center LLC CurrentSince Jun 23, 2018 Accepting new patients

Locations

4143 Fulton Dr NW
Canton, OH 44718
Phone (330) 244-8888

Interoperability endpoints

  • Direct secure messaging: lholliger@scp.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1437605409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 BRUMBAUGH ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207940",
            "telephone_number": "740-262-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 S MAIN ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204245",
            "telephone_number": "330-244-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIGER",
        "first_name": "LAURA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP019548",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP019548",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP019548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.