Blake Ryan Hollowoa, MD

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

71712 Issued in TN

Practice address

9228 Medical Plaza Dr
Charleston, SC 29406-9125

Phone

(843) 574-5693

Fax

(843) 764-4512

NPI assigned

Apr 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Otolaryngology

Education

University of Arkansas College of Medicine, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: blake.hollowoa@hca1.eclinicaldirectplus.com

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

• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1871099499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 24TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031503",
            "telephone_number": "615-342-0290",
            "fax_number": "615-342-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-574-5693",
            "fax_number": "843-764-4512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 543",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-603-1214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 W Markham St # 543",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-603-1214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWOA",
        "first_name": "BLAKE",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "89309",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TN",
            "license": "71712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Ashlyn Holley
• Mary E. Holliday, NP
• Laura Elizabeth Hollinger, M.D.
• Wendy Renee' Hollman, A.T.,C.
• Hailey Jade Holloway, RN
• Catherine A Holly, RD, LD
• Megan Kizer Holly, COTA/L
• Keri Theresa Holmes-Maybank, MD
• Ajani Holmes
• Brianne Holmes, CPNP

• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.