Individual provider Active NPI

Mindy D Holloway, ACNP-BC, FNP-BC

  • Family Nurse Practitioner
  • Winchester, TN
National Provider Identifier
1881852671
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13534 Issued in TN
Practice address
411 Old Mill Rd
Winchester, TN 37398-2444
Phone
(931) 313-8724
Fax
(855) 234-6408
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN13534 TN
Family Nurse Practitioner 363LF0000X 13534 TN Primary

Addresses

Primary practice location

411 Old Mill Rd
Winchester, TN 37398-2444

Mailing address

1467 Bonner Way
Estill Springs, TN 37330-4109
Phone (931) 313-8724

Other identifiers 1

IdentifierTypeStateIssuer
1509754MedicaidTN

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000713 TN Practitioner - Nurse Practitioner 9739240516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN13534TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg - Southern Tennessee, LLC Family CurrentSince Dec 10, 2016 Accepting new patients
Amg-Southern Tennessee LLC Current Accepting new patients
Elite Health and Wellness, PLC CurrentSince Nov 9, 2025 Accepting new patients
Ehw Medical PLLC Acute Care Current Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Dec 10, 2016 Accepting new patients
University of the South Health Services Past Accepting new patients
Dr. Karen a. Tidmore Family Past Accepting new patients

Locations

300 S Main St
Estill Springs, TN 37330
Phone (931) 649-5139

100 Hunters Ln
Tullahoma, TN 37388
Phone (931) 455-4616

100 Hunters Ln
Ste 100
Tullahoma, TN 37388
Phone (931) 455-4616

411 Old Mill Rd
Winchester, TN 37398
Phone (931) 313-8724

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1881852671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 BONNER WAY",
            "city": "ESTILL SPRINGS",
            "state": "TN",
            "postal_code": "373304109",
            "telephone_number": "931-313-8724",
            "fax_number": "855-234-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 OLD MILL RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982444",
            "telephone_number": "931-313-8724",
            "fax_number": "855-234-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "MINDY",
        "middle_name": "D",
        "credential": "ACNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN13534",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509754",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.