NPIMap

Individual provider Active NPI

Hollye R Johnson, MD

  • Nephrology Physician
  • Jackson, MS
National Provider Identifier
1700815321
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
15974 Issued in MS
Practice address
6501 Dogwood View Parkway
Suite a
Jackson, MS 39213
Phone
(601) 899-3340
Fax
(601) 899-3343
NPI assigned
Jul 3, 2006
Last updated
Apr 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15974 MS
Nephrology Physician 207RN0300X 15974 MS Primary

Addresses

Primary practice location

6501 Dogwood View Parkway
Suite a
Jackson, MS 39213

Mailing address

6501 Dogwood View Parkway
Suite a
Jackson, MS 39213
Phone (601) 899-3340

Other identifiers 1

IdentifierTypeStateIssuer
04056301MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008001016 MS Practitioner - NephrologyPractitioner - Internal Medicine 0749249209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Mississippi School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversified Renal Group LLCGroup PAC ID 6406815299, 5 clinicians

Practice addresses (Care Compare)

6501 Dogwood View Pkwy
Suite a
Jackson, MS 39213-7857
Phone (601) 899-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.94 of 100Reported as individual
Quality
60
Improvement activities
40
Cost
73.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15974MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Internal Medicine Assoc LLP Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hollye.johnson@direct.davitaphysiciansolutions.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1700815321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 DOGWOOD VIEW PARKWAY",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-899-3340",
            "fax_number": "601-899-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 DOGWOOD VIEW PARKWAY",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-899-3340",
            "fax_number": "601-899-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HOLLYE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15974",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "15974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04056301",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.