Holly B Byrd

Key facts

NPI

1487072013

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

18608 (TN)

Practice address

2240 Sutherland Ave
Suite 104
Knoxville, TN 37919

Phone

(865) 909-0090

Fax

(865) 909-9883

NPI assigned

Apr 1, 2014

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Summit Medical Group, PLLC Internal Medicine Physician · Brentwood, TN · NPI 1659090298
  Medicare reassignment NPD TN
• Statcare Inpatient LLC Internal Medicine Physician · Knoxville, TN · NPI 1477086981
  NPD
• Summit Medical Group, PLLC Internal Medicine Physician · Maryville, TN · NPI 1255572574
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Holly B Rasar Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 14, 2019.

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1487072013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94670",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731434670",
            "telephone_number": "405-682-3303",
            "fax_number": "405-384-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SUTHERLAND AVE",
            "address_2": "SUITE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37919",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10904 Kingston Pike Ste 103",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379342953",
            "country_code": "US",
            "telephone_number": "865-588-8831",
            "fax_number": "868-588-8841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Fort Loudoun Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lenoir City",
            "state": "TN",
            "postal_code": "377725673",
            "country_code": "US",
            "telephone_number": "865-271-6000",
            "fax_number": "865-271-6245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "988 Oak Ridge Tpke Ste L20",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306944",
            "country_code": "US",
            "telephone_number": "865-444-4321",
            "fax_number": "865-338-5588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "HOLLY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "125341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "RASAR",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Knoxville, TN · Family Nurse Practitioner in Tennessee