NPIMap

Organization Active NPI

Holloway Group Inc

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1497848147
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HOLLOWAY GROUP INC
Practice address
6613 N. Meridian Avenue
Oklahoma City, OK 73116
Phone
(405) 603-8450
Fax
(405) 603-8455
NPI assigned
Oct 2, 2006
Last updated
Oct 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Willis Holloway, Jr, M.D.
Title
Owner/President
Phone
(405) 603-8450

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Neurology Physician 2084N0400X

Addresses

Primary practice location

6613 N. Meridian Avenue
Oklahoma City, OK 73116

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

Other identifiers 1

IdentifierTypeStateIssuer
200036310AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225001056 OK Part B Supplier - Clinic/Group Practice 1951297985 Receives reassigned benefits from 9 practitioners
Practice locations: Oklahoma City, OK; Midwest City, OK; Guthrie, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1049173Holloway Group, the6613 N Meridian Ave, Oklahoma City, OK 73116Certificate of waiverDec 26, 2027

National Provider Directory

National Provider Directory

Locations

605 NW 13th St
Oklahoma City, OK 73103
Phone (405) 239-7101

57523 Moccasin Trail Rd
Prague, OK 74864
Phone (405) 567-0054

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1497848147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "405-603-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6613 N. MERIDIAN AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73116",
            "telephone_number": "405-603-8450",
            "fax_number": "405-603-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLOWAY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY, JR",
        "authorized_official_first_name": "WILLIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "405-603-8450",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200036310A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.