NPIMap

Individual provider Active NPI

Holly Oliveira, FNP

  • Family Nurse Practitioner
  • Lake Kiowa, TX
National Provider Identifier
1497749147
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
564679 Issued in TX
Practice address
100 Kiowa Dr W
Suite 103
Lake Kiowa, TX 76240-9584
Phone
(940) 612-5562
Fax
(940) 665-6201
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 564679 TX Primary

Addresses

Primary practice location

100 Kiowa Dr W
Suite 103
Lake Kiowa, TX 76240-9584

Mailing address

PO Box 1358
Gainesville, TX 76241-1358
Phone (940) 612-5562

Other identifiers 1

IdentifierTypeStateIssuer
141099502MedicaidTX

Other names 1

  • Holly Wellman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060406000242 TX Practitioner - Nurse Practitioner 7113936956 Reassigns benefits to 2 organizations
Practice locations: Lake Kiowa, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Kiowa Dr W
Apt 103
Gainesville, TX 76240-9507
Phone (940) 612-5562

Hospital & facility affiliations

  • Choice Health at Home Home health agency, Gainsville, TX, CCN 747302
  • Angels Care Home Health Home health agency, Decatur, TX, CCN 457786
  • Pilot Point Home Health Inc Home health agency, Whitesboro, TX, CCN 677532
  • First Texas Home Health Home health agency, Whitesboro, TX, CCN 458193
  • North Texas Medical Center Hospital, Gainesville, TX, CCN 450090
  • Texoma Medical Center Hospital, Denison, TX, CCN 450324
  • Medical City Denton Hospital, Denton, TX, CCN 450634
  • The Heart Hospital Baylor Denton Hospital, Denton, TX, CCN 450893
  • Texas Health Presbyterian Hospital Denton Hospital, Denton, TX, CCN 450743

Merit-based Incentive Payment System (MIPS)

Final score
25.19 of 100Reported as individual
Quality
31.67
Improvement activities
0
Cost
41.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
564679TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Kiowa Medical Clinic CurrentSince Feb 28, 2019 Accepting new patients
Gainesville Hospital District PastSince Jun 13, 2024 Accepting new patients

Locations

100 Kiowa Dr W
Ste 103
Lake Kiowa, TX 76240
Phone (940) 612-5562

100 Kiowa Dr W
Apt 103
Lake Kiowa, TX 76240
Phone (940) 612-5562

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 9

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1497749147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762411358",
            "telephone_number": "940-612-5562",
            "fax_number": "940-665-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KIOWA DR W",
            "address_2": "SUITE 103",
            "city": "LAKE KIOWA",
            "state": "TX",
            "postal_code": "762409584",
            "telephone_number": "940-612-5562",
            "fax_number": "940-665-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEIRA",
        "first_name": "HOLLY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "564679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141099502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "WELLMAN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Kiowa, TX

Sources for this page

Verify at the official NPI Registry.