Individual provider Active NPI

Holly Jennifer Irwin, M.D.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1689028474
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01085135A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 944-4034
NPI assigned
Apr 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11018946A IN
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 1689028474 IN
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 01085135A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959
Phone (317) 962-3834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210308000737 IN Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 4587963665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1689028474INMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Feb 10, 2021 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5208 Reliable Pkwy
Chicago, IL 60686

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

301 Henry St
North Vernon, IN 47265
Phone (812) 352-4200

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 5

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1689028474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-962-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "HOLLY",
        "middle_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "11018946A",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IN",
            "license": "1689028474",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01085135A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.