Individual provider Active NPI

Nichole Ashley Hollingsworth, CRNA

  • Certified Registered Nurse Anesthetist
  • Durham, NC
National Provider Identifier
1700456118
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7254 Issued in NC
Practice address
5921 Tahoe Dr
Durham, NC 27713-8628
Phone
(949) 294-7076
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 325465 NC
Certified Registered Nurse Anesthetist 367500000X 7254 NC Primary

Addresses

Primary practice location

5921 Tahoe Dr
Durham, NC 27713-8628

Mailing address

5921 Tahoe Dr
Durham, NC 27713-8628
Phone (949) 294-7076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231121003374 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820446305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
325465NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Nov 6, 2023 Accepting new patients
Pender Memorial Hospital, Incorporated CurrentSince Jul 12, 2024 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 6, 2023 Accepting new patients
Pender Memorial Hospital Incorporated CurrentSince Jul 12, 2024 Accepting new patients
Pender Memorial Hospital Incorporated Current Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1700456118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5921 TAHOE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138628",
            "telephone_number": "949-294-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 TAHOE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138628",
            "telephone_number": "949-294-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "NICHOLE",
        "middle_name": "ASHLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "325465",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "7254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.