Individual provider Active NPI

India Kenyonda Holloway, MD

  • Hospitalist Physician
  • Greenville, SC
National Provider Identifier
1750721668
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35938 Issued in SC
Practice address
701 Grove Rd FL 5
Greenville, SC 29605-4210
Phone
(864) 455-4411
Fax
(864) 455-4480
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD35938 SC
Internal Medicine Physician 207R00000X 75673 GA
Hospitalist Physician 208M00000X 35938 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 5
Greenville, SC 29605-4210

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160518001787 GA Practitioner - Internal Medicine 5890084610 Reassigns benefits to 4 organizations
Practice locations: Columbus, GA
I20190926003094 FL Practitioner - Internal Medicine 5890084610 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75673GAMDInternal Medicine Physician
MD35938SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benning Hospitalist Services, LLC Hospitalist CurrentSince Mar 6, 2018 Accepting new patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Sep 19, 2018 Accepting new patients
Laureate Medical Group at Northside LLC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-3960

3400 Old Milton Pkwy
Ste 500
Alpharetta, GA 30005
Phone (678) 775-2284

550 Peachtree St NE
Ste 1550
Atlanta, GA 30308
Phone (404) 892-2131

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

6135 Barfield Rd
Ste 200
Sandy Springs, GA 30328
Phone (404) 256-8500

6600 Peachtree Dunwoody Rd
Bldg 600
Sandy Springs, GA 30328

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1750721668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 5",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-4411",
            "fax_number": "864-455-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "INDIA",
        "middle_name": "KENYONDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "MD35938",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "75673",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "35938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.