Individual provider Active NPI

Richard Wayne Hollings, PH.D

  • Psychologist
  • Fayetteville, NC
National Provider Identifier
1811053713
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1804 Issued in NC
Practice address
114 Highland Ave
Fayetteville, NC 28305-5306
Phone
(910) 484-0176
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1804 NC Primary

Addresses

Primary practice location

114 Highland Ave
Fayetteville, NC 28305-5306

Mailing address

206 Oakridge Ave
Fayetteville, NC 28305-4837
Phone (910) 485-6014

Other identifiers 2

IdentifierTypeStateIssuer
95789OtherNCMEDCOST
03925OtherNCBCBS

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1804NCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1811053713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 OAKRIDGE AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054837",
            "telephone_number": "910-485-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HIGHLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055306",
            "telephone_number": "910-484-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGS",
        "first_name": "RICHARD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "95789",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03925",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.