Organization Active NPI

Marie Hollis, M.D. PLLC

  • Obstetrics & Gynecology Physician
  • Greenville, TX
National Provider Identifier
1871881821
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
N8191 Issued in TX
Legal business name
MARIE HOLLIS, M.D. PLLC
Practice address
3900 Joe Ramsey Blvd E Ste E
Greenville, TX 75401-7770
Phone
(903) 454-1722
Fax
(903) 454-1750
NPI assigned
Jul 12, 2011
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Kristi D Phipps- Warren
Title
Employee/ Credentialing
Phone
(903) 454-1722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X N8191 TX Primary

Addresses

Primary practice location

3900 Joe Ramsey Blvd E Ste E
Greenville, TX 75401-7770

Mailing address

3900 Joe Ramsey Blvd E Ste E
Greenville, TX 75401-7770
Phone (903) 454-1722

Other identifiers 1

IdentifierTypeStateIssuer
282877402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000067 TX Part B Supplier - Clinic/Group Practice 0840451670 Receives reassigned benefits from 7 practitioners
Practice locations: Greenville, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1871881821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JOE RAMSEY BLVD E STE E",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017770",
            "telephone_number": "903-454-1722",
            "fax_number": "903-454-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JOE RAMSEY BLVD E STE E",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017770",
            "telephone_number": "903-454-1722",
            "fax_number": "903-454-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE HOLLIS, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "PHIPPS- WARREN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EMPLOYEE/ CREDENTIALING",
        "authorized_official_telephone_number": "903-454-1722"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N8191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282877402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.