Luke Brandon Holly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008553 Issued in MI

Practice address

124 Navaho TRL
Buckley, MI 49620-9527

Phone

(231) 878-8310

NPI assigned

Jan 31, 2018

Last updated

Nov 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Ecs Central Michigan PC

  • Emergency Medicine Physician
  • Owosso, MI
  • NPI 1043711930
  Medicare reassignment
• Interlochen Emergency Group, P.C.

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1336821495
  Medicare reassignment
• Munson Medical Center

  dba Endocrinology and Metabolism

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360
  Medicare reassignment
• Munson Medical Center

  dba Munson Healthcare Neurology - Traverse City

  • Neurology Physician
  • Traverse City, MI
  • NPI 1326645698
  NPD
• Paul Oliver Memorial Hospital

  • Skilled Nursing Facility
  • Frankfort, MI
  • NPI 1649133943
  NPD
• Paul Oliver Memorial Hospital

  • Audiologist
  • Frankfort, MI
  • NPI 1669024519
  NPD

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1619475969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NAVAHO TRL",
            "city": "BUCKLEY",
            "state": "MI",
            "postal_code": "496209527",
            "telephone_number": "231-878-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NAVAHO TRL",
            "city": "BUCKLEY",
            "state": "MI",
            "postal_code": "496209527",
            "telephone_number": "231-878-8310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "MI",
            "postal_code": "496359658",
            "country_code": "US",
            "telephone_number": "231-352-2200",
            "fax_number": "231-352-2232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLY",
        "first_name": "LUKE",
        "middle_name": "BRANDON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-31",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Ann Bach, DPT
• Heidi Hansen Burgess, PT
• Heidi Fite, PA-C
• Gregory G North PHD PC
• Mitzie Jean Hewitt, D.O.
• Joan M Ledford, LPC, NCC
• Katelyn McDonald, LMSW
• Kelly R McDonough, PT
• Carrie Lee Minto, PA-C
• Gregory Guy North, PH.D.

• Physician Assistant in Buckley, MI
• Providers in Buckley, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.