Individual provider Active NPI

Carl M Hollmann, MD

  • Orthopaedic Surgery Physician
  • Cookeville, TN
National Provider Identifier
1669469722
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD014296 Issued in TN
Practice address
105 S Willow Ave
Cookeville, TN 38501-3138
Phone
(931) 526-9518
Fax
(931) 372-0087
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD014296 TN Primary

Addresses

Primary practice location

105 S Willow Ave
Cookeville, TN 38501-3138

Mailing address

105 S Willow Ave
Cookeville, TN 38501-3138
Phone (931) 526-9518

Other identifiers 2

IdentifierTypeStateIssuer
200013070OtherTNPTAN MEDICARE RAILROAD
3026678MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101119000733 TN Practitioner - Orthopedic Surgery 3274502489 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14296TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Livingston LLC Orthopaedic Surgery CurrentSince Dec 1, 2014 Accepting new patients
Amg - Livingston, LLC CurrentSince Dec 1, 2014 Accepting new patients
Upper Cumberland Orthopedic Surgery, PC Orthopaedic Surgery Past Accepting new patients
White County Physician Services Inc Past Accepting new patients

Locations

310 Oak St
#B
Livingston, TN 38570
Phone (931) 403-5175

Organizations & group practices 4

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1669469722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013138",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013138",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLMANN",
        "first_name": "CARL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD014296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MEDICARE RAILROAD",
            "identifier": "200013070",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3026678",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.