Individual provider Active NPI

Marisa Olivia Hollinshead, MD

  • Psychiatry Physician
  • Providence, RI
National Provider Identifier
1851021695
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
05723 Issued in RI
Practice address
345 Blackstone Blvd Ste 2
Providence, RI 02906-4829
Phone
(401) 455-6375
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 05723 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd Ste 2
Providence, RI 02906-4829

Mailing address

345 Blackstone Blvd
Providence, RI 02906-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220709000509 RI Order and Referring Only - PsychiatryPractitioner - Psychiatry 1850771759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05723RIMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1851021695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD STE 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064829",
            "telephone_number": "401-455-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINSHEAD",
        "first_name": "MARISA",
        "middle_name": "OLIVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "05723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.