Andy Wade Holley, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

23290 Issued in MS

Practice address

703 Alcorn Dr Ste 102
Corinth, MS 38834-9302

Phone

(662) 286-2522

NPI assigned

Apr 30, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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 2

Specialty

General Surgery

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Ut Methodist Physicians LLCGroup PAC ID 2769623669, 123 clinicians

Magnolia Surgical GroupGroup PAC ID 6204825755, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msg@magnolia.medalliesdirect.net

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.

• Magnolia Surgical Group

  • Surgery Physician
  • Corinth, MS
  • NPI 1134142284

  MS, Surgery

  Medicare reassignment Care Compare group NPD
• Ut Methodist Physicians LLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1427317908

  MS, Surgery, TN

  Medicare reassignment Care Compare group NPD
• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445

  MS

  Medicare reassignment NPD
• Magnolia Regional Health Center

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1093546566
  NPD
• Magnolia Regional Health Center

  • Certified Registered Nurse Anesthetist
  • Corinth, MS
  • NPI 1245410398
  NPD
• Magnolia Regional Health Center

  • Pulmonary Disease Physician
  • Corinth, MS
  • NPI 1689906117
  NPD
• Magnolia Regional Health Center

  • Emergency Medicine Physician
  • Corinth, MS
  • NPI 1922266857
  NPD
• Magnolia Women'S Center

  • Obstetrics & Gynecology Physician
  • Corinth, MS
  • NPI 1639617970
  NPD (past)
• Ut Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Memphis, TN
  • NPI 1780676650

  Surgery

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445

  Hospital

  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1700020005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 FIELDSTONE FARMS RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388347561",
            "telephone_number": "662-678-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ALCORN DR STE 102",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349302",
            "telephone_number": "662-286-2522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 Eastmoreland Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381047544",
            "country_code": "US",
            "telephone_number": "901-758-7970",
            "fax_number": "901-266-6425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4240 Bethel Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-758-7970",
            "fax_number": "901-266-6425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "ANDY",
        "middle_name": "WADE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "5474",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "23290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msg@magnolia.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "703 Alcorn Dr Ste 102",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388349302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wanda Newby Hill, DNP FNP, FPMHNP-BC
• Shannon Marlar Hinds, RD, LD
• Daniel Wayne Hinton, PHARM.D.
• Patrick Hinton, DPT
• Renee Denise Holcomb
• April Holley, APRN, FNP-C
• April Renee Holley, CRNA
• Tiffany Thomas Hollingsworth, DMD
• Brieanna Holmes
• Bryn Holte

• All providers in Corinth, MS
• Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.