Active NPI
Lissa S Holloway, PA
- Physician Assistant
- Britt, IA
National Provider Identifier
1497770630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000789
- Practice address
- 532 1St St NW
Britt, IA 50423-1227 - Phone
- (641) 843-5050
- Fax
- (641) 843-5051
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000789 | IA | Primary |
Addresses
Primary practice location
532 1St St NW
Britt, IA 50423-1227
Mailing address
532 1St St NW
Britt, IA 50423-1227
Phone (641) 843-5050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42915 | Other | IA | WELLMARK BRITT CLINIC |
| 42917 | Other | IA | WELLMARK - KANAWHA CLINIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 789 | IA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Past | Accepting new patients | |
| Hancock County Health System | Past | Accepting new patients | |
| Hancock County Memorial Hospital | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Boone, IA
- NPI 1467434225
-
- Critical Access Hospital
- Britt, IA
- NPI 1689721318
-
- Cardiovascular Disease Physician
- Britt, IA
- NPI 1831303973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497770630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "532 1ST ST NW",
"city": "BRITT",
"state": "IA",
"postal_code": "504231227",
"telephone_number": "641-843-5050",
"fax_number": "641-843-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "532 1ST ST NW",
"city": "BRITT",
"state": "IA",
"postal_code": "504231227",
"telephone_number": "641-843-5050",
"fax_number": "641-843-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "LISSA",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "000789",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BRITT CLINIC",
"identifier": "42915",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK - KANAWHA CLINIC",
"identifier": "42917",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Britt, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.