Individual provider Active NPI

Marie Carline Hollant, CNP

  • Gerontology Nurse Practitioner
  • South Weymouth, MA
National Provider Identifier
1467033522
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG02210090 Issued in MA
Practice address
55 Fogg Rd
South Weymouth, MA 02190-2455
Phone
(781) 624-8000
NPI assigned
Apr 19, 2021
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG02210090 MA Primary

Addresses

Primary practice location

55 Fogg Rd
South Weymouth, MA 02190-2455

Mailing address

22 Bellevue PL
Avon, MA 02322-1432
Phone (774) 297-4727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230327001516 MA Practitioner - Nurse Practitioner 2567836950 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG02210090MAMDGerontology Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1467033522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BELLEVUE PL",
            "city": "AVON",
            "state": "MA",
            "postal_code": "023221432",
            "telephone_number": "774-297-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902455",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANT",
        "first_name": "MARIE",
        "middle_name": "CARLINE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "AG02210090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

Verify at the official NPI Registry.