Individual provider Active NPI

Erin Marie Holleman, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Malvern, AR
National Provider Identifier
1801021696
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A003237 Issued in AR
Practice address
1517 S Main St
Malvern, AR 72104
Phone
(501) 332-7525
NPI assigned
May 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X A003237 AR Primary

Addresses

Primary practice location

1517 S Main St
Malvern, AR 72104

Mailing address

PO Box 1848
Mena, AR 71953-1841
Phone (479) 437-3449

Other practice location 1

1517 S Main St
Malvern, AR 72104
Phone (501) 332-7525

Other identifiers 1

IdentifierTypeStateIssuer
179696758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090818000596 AR Practitioner - Nurse Practitioner 5395899884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1401 Malvern Ave
Suite 100
Hot Springs, AR 71901-6376
Phone (501) 601-5107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A003237ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Natural State Behavioral Health Psychiatric/Mental Health CurrentSince Dec 1, 2020 Accepting new patients

Locations

1401 Malvern Ave
Ste 100
Hot Springs, AR 71901
Phone (501) 844-1902

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1801021696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531841",
            "telephone_number": "479-437-3449",
            "fax_number": "479-243-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 S MAIN ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "72104",
            "telephone_number": "501-332-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1517 S Main St",
            "address_purpose": "LOCATION",
            "city": "Malvern",
            "state": "AR",
            "postal_code": "72104",
            "country_code": "US",
            "telephone_number": "501-332-7525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEMAN",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A003237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179696758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.