Individual provider Active NPI

Dominique Starr Crosby Holley, D.O.

  • Psychiatry Physician
  • Nashville, TN
National Provider Identifier
1639433360
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3796 Issued in TN
Practice address
315 Deaderick St Ste 1550
Nashville, TN 37238-3003
Phone
(833) 351-8255
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 3796 TN
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 327418 NY
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 0102203789 VA
Psychiatry Physician 2084P0800X 0102203789 VA
Psychiatry Physician 2084P0800X 327418 NY
Child & Adolescent Psychiatry Physician 2084P0804X 3796 TN
Child & Adolescent Psychiatry Physician 2084P0804X 0102203789 VA
Child & Adolescent Psychiatry Physician 2084P0804X 327418 NY
Psychiatry Physician 2084P0800X 3796 TN Primary

Addresses

Primary practice location

315 Deaderick St Ste 1550
Nashville, TN 37238-3003

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (301) 295-4611

Other practice location 2

2800 Eisenhower Ave Ste 220
Alexandria, VA 22314-4587
Phone (833) 351-8255

Other practice location 3

109 W 27th St Ste 5S
New York, NY 10001-0265
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NY, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231211000388 TN Practitioner - Psychiatry 9335364116 Reassigns benefits to 1 organization
I20240222003857 NY Practitioner - Psychiatry 9335364116 Reassigns benefits to 1 organization
I20240824000344 DC Practitioner - Psychiatry 9335364116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

1775 I St NW
Suite 1150 Talkiatry
Washington, DC 20006-2435
Phone (833) 351-8255

315 Deaderick St
Suite 1550
Nashville, TN 37238-3003
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102203789VAMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2024 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Feb 13, 2024 Accepting new patients

Locations

1775 I St NW
Ste 1150
Washington, DC 20006
Phone (202) 313-7696

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

109 W 27th St
#55
New York, NY 10001

315 Deaderick St
Ste 1550
Nashville, TN 37238
Phone (615) 554-3233

2800 Eisenhower Ave
Ste 220
Alexandria, VA 22314
Phone (540) 358-0423

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.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1639433360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 DEADERICK ST STE 1550",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372383003",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235318",
            "country_code": "US",
            "telephone_number": "301-295-4611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Eisenhower Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223144587",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 W 27th St Ste 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100010265",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "DOMINIQUE",
        "middle_name": "STARR CROSBY",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "TN",
            "license": "3796",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "327418",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "VA",
            "license": "0102203789",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102203789",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "327418",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "3796",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0102203789",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "327418",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "3796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.