Individual provider Active NPI

Teresa Ann Holland, FNP-BC

  • Nurse Practitioner
  • Kenansville, NC
National Provider Identifier
1861697310
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0050-02921 Issued in NC
Practice address
140 Limestone Rd
Kenansville, NC 28349
Phone
(910) 275-0195
Fax
(910) 275-0192
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0050-02921 NC Primary

Addresses

Primary practice location

140 Limestone Rd
Kenansville, NC 28349

Mailing address

140 Limestone Rd
Kenansville, NC 28349
Phone (910) 275-0195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20081218000238 NC Practitioner - Nurse Practitioner 3274695630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Medical Center IncorporatedGroup PAC ID 3173434479, 96 clinicians

Practice addresses (Care Compare)

102 N Main St
Suite 1
Kenansville, NC 28349-8966
Phone (910) 275-0195

444 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0421

460 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0951

Hospital & facility affiliations

  • Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
  • Vidant Duplin Hospital Hospital, Kenansville, NC, CCN 340120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0050-02921NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 1, 2018 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 1, 2018 Accepting new patients
Long Term Care Nurse Practitioner Services, LLC Nurse Practitioner Past Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients

Locations

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

261 Sloop Point Loop Rd
Hampstead, NC 28443
Phone (910) 285-2330

102 Main St
Ste 2
Kenansville, NC 28349
Phone (910) 275-0195

102 Main St
Kenansville, NC 28349
Phone (910) 296-1087

102 Main St
Ste 1
Kenansville, NC 28349
Phone (910) 275-0195

603 E College St
Warsaw, NC 28398
Phone (910) 293-3900

Interoperability endpoints

  • Direct secure messaging: tholland@goshenmedical.cloudcraftdirect.com

Organizations & group practices 5

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 2

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1861697310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LIMESTONE RD",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-275-0195",
            "fax_number": "910-275-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LIMESTONE RD",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-275-0195",
            "fax_number": "910-275-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "0050-02921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenansville, NC

Sources for this page

Verify at the official NPI Registry.