Active NPI
Kelley M Hollingsworth, LPN
- Licensed Practical Nurse
- Warren, AR
National Provider Identifier
1558602003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L51305
- Practice address
- 1404 East Church Street
Warren, AR 71671 - Phone
- (870) 226-5856
- Fax
- (870) 226-6208
- NPI assigned
- Mar 8, 2013
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L51305 | AR | Primary |
Addresses
Primary practice location
1404 East Church Street
Warren, AR 71671
Mailing address
790 Roberts Drive
Monticello, AR 71655
Phone (870) 367-2461
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L51305 | AR | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Counseling Associates Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Monticello, AR
- NPI 1053364612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1558602003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 ROBERTS DRIVE",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "71655",
"telephone_number": "870-367-2461",
"fax_number": "870-460-6133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 EAST CHURCH STREET",
"city": "WARREN",
"state": "AR",
"postal_code": "71671",
"telephone_number": "870-226-5856",
"fax_number": "870-226-6208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLINGSWORTH",
"first_name": "KELLEY",
"middle_name": "M",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-08",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AR",
"license": "L51305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.