Jonathan Holloway, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

74509 Issued in ID

Practice address

803 S Main St Ste 210
Moscow, ID 83843-2695

Phone

(509) 228-1000

Fax

(509) 252-9300

NPI assigned

Oct 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MP, WA, HI3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hilo Benioff Medical CenterGroup PAC ID 1254422900, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1962584060
  Medicare reassignment Care Compare group NPD
• Commonwealth Healthcare Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saipan, MP
  • NPI 1285858290
  Medicare reassignment NPD
• Cancer Care Northwest Centers P S

  • Hematology & Oncology Physician
  • Spokane Valley, WA
  • NPI 1922072081
  Medicare reassignment
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  NPD
• Hilo Benioff Medical Center

  • Anesthesiology Physician
  • Hilo, HI
  • NPI 1235981614
  NPD
• Palouse Specialty Physicians, P.S.

  • Otolaryngology Physician
  • Pullman, WA
  • NPI 1760889265
  NPD
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  Care Compare affiliation

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1760089841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500409",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "969500409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST STE 210",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432695",
            "telephone_number": "509-228-1000",
            "fax_number": "509-252-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-02",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MP",
            "license": "R190104",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN208920",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-4900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "248356",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "74509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice of the Palouse

• Nurse Practitioner in Moscow, ID
• Providers in Moscow, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.