NPIMap

Individual provider Active NPI

Kimberly Sue Holloway, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1447209374
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20987 Issued in SC
Practice address
330 Pelham Rd Ste 101C
Greenville, SC 29615-3111
Phone
(864) 720-1299
Fax
(864) 720-1300
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 20987 SC
Obstetrics & Gynecology Physician 207V00000X 20987 SC Primary

Addresses

Primary practice location

330 Pelham Rd Ste 101C
Greenville, SC 29615-3111

Mailing address

330C Pelham Rd Ste a
Greenville, SC 29615-3111
Phone (864) 720-1299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000354 SC Practitioner - Obstetrics/Gynecology 5799734737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ps121 Management PAGroup PAC ID 2264786706, 5 clinicians

Practice addresses (Care Compare)

330 C Pelham Rd
Suite a
Greenville, SC 29615-3111
Phone (864) 720-1299

Hospital & facility affiliations

  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20987SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ps121 Management PA Obstetrics & Gynecology CurrentSince Oct 1, 2018 Accepting new patients
Greenville Health System Past Accepting new patients

Locations

330C Pelham Rd
#A
Greenville, SC 29615
Phone (864) 720-1299

274 Commonwealth Dr
Ste A
Greenville, SC 29615
Phone (864) 686-5511

Interoperability endpoints

  • Direct secure messaging: kholloway5633@direct.ghs.myhfn.org

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.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1447209374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330C PELHAM RD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153111",
            "telephone_number": "864-720-1299",
            "fax_number": "864-720-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PELHAM RD STE 101C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153111",
            "telephone_number": "864-720-1299",
            "fax_number": "864-720-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": "20987",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "20987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.