Active NPI
Rebecca Holliman, MSN, NP-C, RN-BC
- Nurse Practitioner
- Mount Dora, FL
National Provider Identifier
1629348677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP 832602
- Practice address
- 3619 Lake Center Dr
Mount Dora, FL 32757-2364 - Phone
- (352) 383-8222
- Fax
- (352) 383-1420
- NPI assigned
- Jan 9, 2012
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP 832602 | FL | Primary |
Addresses
Primary practice location
3619 Lake Center Dr
Mount Dora, FL 32757-2364
Mailing address
3619 Lake Center Dr
Mount Dora, FL 32757-2364
Phone (352) 383-8222
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
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 832602 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Imaging LLC | Past | Accepting new patients | |
| Adult Medicine of Lake County Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JEJFAA
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Mount Dora, FL
- NPI 1851450209
-
- Diagnostic Radiology Physician
- Orange Park, FL
- NPI 1346516853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326067200000",
"number": "1629348677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3619 LAKE CENTER DR",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572364",
"telephone_number": "352-383-8222",
"fax_number": "352-383-1420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3619 LAKE CENTER DR",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572364",
"telephone_number": "352-383-8222",
"fax_number": "352-383-1420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIMAN",
"first_name": "REBECCA",
"credential": "MSN, NP-C, RN-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-09",
"last_updated": "2012-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP 832602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.