Individual provider Active NPI

Holly Ely, CRNA

  • Certified Registered Nurse Anesthetist
  • Carrollton, GA
National Provider Identifier
1801415872
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
GAA-CRNA003198 Issued in GA
Practice address
705 Dixie St
Carrollton, GA 30117-3818
Phone
(770) 812-9666
NPI assigned
Apr 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X GAA-CRNA003198 GA Primary

Addresses

Primary practice location

705 Dixie St
Carrollton, GA 30117-3818

Mailing address

143 Gwendolyn CT
Carrollton, GA 30117-8103
Phone (770) 328-1089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211229002264 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284059684 Reassigns benefits to 1 organization
I20250430003222 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284059684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC-West Georgia Anesthesia Associates Inc.Group PAC ID 2365456308, 67 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (800) 232-5703

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
6771NCMDDentist
23975SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Norman Anesthesia Associates CurrentSince Dec 21, 2021 Accepting new patients
TMC-West Georgia Anesthesia Associates Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Mobile Anesthesia, LLC Past Accepting new patients

Locations

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

114 Commerce Center Loop
Ste B
Mooresville, NC 28117
Phone (704) 662-0877

146 Medical Park Rd
Ste 108
Mooresville, NC 28117
Phone (704) 662-0876

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1801415872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 GWENDOLYN CT",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301178103",
            "telephone_number": "770-328-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-812-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "HOLLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "GAA-CRNA003198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.