Amanda Lynn Holloway

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

008289 Issued in AZ

Practice address

126 E Main St Ste B
Payson, AZ 85541-5488

Phone

(928) 468-8610

NPI assigned

Apr 12, 2017

Last updated

Mar 22, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Solace Health Medical Group Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Redwood City, CA
  • NPI 1801669924

  NJ

  Medicare reassignment NPD
• North Country Healthcare Inc

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1093146755
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675
  NPD

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1447784848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-522-9879",
            "fax_number": "928-522-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415488",
            "telephone_number": "928-468-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060405921",
            "country_code": "US",
            "telephone_number": "860-533-4679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "009528503",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "008289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin M Heaton
• Hellsgate Fire District (Rim Country Fire and Medical Service)
• Herring DDS PLLC (Doze PLLC)
• Shelley Marie Hill
• Richard D Hobson, PA-C
• Debra Jean Hooper
• Durstin W Hooper, DDS
• Hospice of Payson, LLC Dba Covenant Hospice
• Ashley Nicole Hughes, CRNA
• Ray Dauson Hughes, M.D.

• Family Medicine Physician in Payson, AZ
• Providers in Payson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.