Individual provider Active NPI

Pamela Holler, N.P.

  • Family Nurse Practitioner
  • Ft Collins, CO
National Provider Identifier
1497742290
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
102839 Issued in CO
Practice address
1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311
Phone
(970) 493-7733
Fax
(970) 493-8745
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 102839 CO Primary

Addresses

Primary practice location

1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311

Mailing address

1600 Specht Point Rd
Suite 127
Ft Collins, CO 80525-4311
Phone (970) 493-7733

Other identifiers 1

IdentifierTypeStateIssuer
79431348MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20050225000771 CO Practitioner - Nurse Practitioner 1456304716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Clinic PCGroup PAC ID 7315914405, 18 clinicians

Practice addresses (Care Compare)

3351 Eastbrook Dr
Suite 100
Fort Collins, CO 80525-5744
Phone (970) 493-7733

Hospital & facility affiliations

  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102839COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Clinic PC CurrentSince Jun 1, 2005 Accepting new patients
Fort Collins Skin Clinic, P.C. Past Accepting new patients

Locations

1600 Specht Point Rd
Ste 127
Fort Collins, CO 80525

3351 Eastbrook Dr
Ste 100
Fort Collins, CO 80525

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

2988 Ginnala Dr
Loveland, CO 80538
Phone (970) 633-0815

620 Iris Dr
Sterling, CO 80751
Phone (970) 313-2740

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1497742290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "SUITE 127",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SPECHT POINT RD",
            "address_2": "SUITE 127",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805254311",
            "telephone_number": "970-493-7733",
            "fax_number": "970-493-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "PAMELA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "102839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79431348",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Collins, CO

Sources for this page

Verify at the official NPI Registry.