Active NPI
Holly A. Vancleave, M.D.
- Internal Medicine Physician
- Temple, TX
National Provider Identifier
1629030192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- K5730
- Practice address
- 1608 S 31St St
Temple, TX 76508-0001 - Phone
- (254) 724-2111
- NPI assigned
- Apr 3, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | K5730 | TX | Primary |
Addresses
Primary practice location
1608 S 31St St
Temple, TX 76508-0001
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1054603-01 | Medicaid | TX | |
| 1054603-02 | Other | TX | CSHCN |
| 81754Y | Other | TX | BLUE SHIELD |
| 110210858 | Other | TX | RR/MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hvancleave13151@direct.sw.org |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K5730 | TX | MD | Internal Medicine Physician |
Interoperability endpoints
- holly.van.cleave.1@23838.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1629030192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1608 S 31ST ST",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765080001",
"telephone_number": "254-724-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCLEAVE",
"first_name": "HOLLY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2022-03-31",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "K5730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1054603-01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "1054603-02",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "81754Y",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "110210858",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hvancleave13151@direct.sw.org",
"affiliation": "N",
"address_1": "1608 S 31st St",
"city": "Temple",
"state": "TX",
"country_code": "US",
"postal_code": "765080001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.