Active NPI
Eloise W Hollen, MNT
- Registered Dietitian
- Elkins, WV
National Provider Identifier
1740350123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 392970
- Practice address
- 812 Gorman Avenue
Elkins, WV 26241 - Phone
- (304) 636-3300
- NPI assigned
- Nov 9, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 392970 | WV | Primary |
Addresses
Primary practice location
812 Gorman Avenue
Elkins, WV 26241
Mailing address
812 Gorman Avenue
Elkins, WV 26241
Phone (304) 636-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00422763 | Other | WV | RAILROAD MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 392970 | WV | MD | Registered Dietitian |
| 11 | WV | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Memorial Hospital | Current | Accepting new patients |
Locations
812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300
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.
-
- General Acute Care Hospital
- Elkins, WV
- NPI 1619964806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1740350123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 GORMAN AVENUE",
"city": "ELKINS",
"state": "WV",
"postal_code": "26241",
"telephone_number": "304-636-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 GORMAN AVENUE",
"city": "ELKINS",
"state": "WV",
"postal_code": "26241",
"telephone_number": "304-636-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLEN",
"first_name": "ELOISE",
"middle_name": "W",
"credential": "MNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WV",
"license": "392970",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00422763",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.