Individual provider Active NPI

Colleen Marie Holden, PAC

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1740278423
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
101541 Issued in NC
Practice address
700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone
(704) 334-7800
NPI assigned
Oct 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 101541 NC Primary

Addresses

Primary practice location

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788

Mailing address

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone (704) 334-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000358 NC Practitioner - Physician Assistant 7416905401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101541NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Nov 1, 2000 Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

12335 N Community House Rd
Ste B
Charlotte, NC 28277

1001 Blythe Blvd
Ste 300
Charlotte, NC 28203

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

Organizations & group practices 1

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1740278423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.