Holly Erin Dallas, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036136967 Issued in IL

Practice address

1701 W. Curtis Rd
Champaign, IL 61822-9678

Phone

(217) 365-6207

Fax

(217) 365-6380

NPI assigned

May 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Holly Erin Regnier Former name

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Internal Medicine

Education

Southern Illinois University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ameriwound Physicians Il LLCGroup PAC ID 2860616299, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ameriwound Physicians Il LLC

  • General Practice Physician
  • Skokie, IL
  • NPI 1104245893
  Medicare reassignment Care Compare group NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Osf Healthcare System

  • General Acute Care Hospital
  • Danville, IL
  • NPI 1699288449
  Care Compare affiliation

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1811289309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W. CURTIS RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618229678",
            "telephone_number": "217-365-6207",
            "fax_number": "217-365-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "HOLLY",
        "middle_name": "ERIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036136967",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "REGNIER",
            "middle_name": "ERIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenny M. Daab, PNP
• Elizabeth Dahl
• Diane Lynn Dailey, M.S.
• Parameshwaraiah S. Dakshinesh, MD
• Rob Dalhaus III
• Carl Daly
• Deidra Dame, LSW
• Steven J Damore, M.D.
• Katherine Dams
• Dana E. Fender, D.M.D., P.C.

• Internal Medicine Physician in Champaign, IL
• Providers in Champaign, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.