Active NPI
Nancy Marie Hollowell, PA
- Physician Assistant
- Grand Rapids, MI
National Provider Identifier
1720699226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10003078A
- Practice address
- 200 Jefferson Ave SE
Grand Rapids, MI 49503-4502 - Phone
- (616) 685-6902
- Fax
- (616) 685-8995
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 10003078A | IN | Primary |
Addresses
Primary practice location
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Mailing address
470 9 Mile Rd NE
Comstock Park, MI 49321-9685
Phone (812) 786-4630
Other practice location 1
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-2000
Other practice location 2
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 274-4779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10003078A | IN | MD | Physician Assistant |
Interoperability endpoints
- nhollowell1528709@direct.trinity-health.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1720699226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 9 MILE RD NE",
"city": "COMSTOCK PARK",
"state": "MI",
"postal_code": "493219685",
"telephone_number": "812-786-4630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034502",
"telephone_number": "616-685-6902",
"fax_number": "616-685-8995"
}
],
"practiceLocations": [
{
"address_1": "1500 E Sherman Blvd",
"address_purpose": "LOCATION",
"city": "Muskegon",
"state": "MI",
"postal_code": "494441849",
"country_code": "US",
"telephone_number": "231-672-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "705 Riley Hospital Dr",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-274-4779",
"fax_number": "317-948-9806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLOWELL",
"first_name": "NANCY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-10",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10003078A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.