Individual provider Active NPI

Brian Carl Hollimon, FNP-BC

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1881920817
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R852028 Issued in MS
Practice address
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone
(601) 296-3600
NPI assigned
Oct 27, 2009
Last updated
Oct 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R852028 MS Primary

Addresses

Primary practice location

5001 Hardy St
Hattiesburg, MS 39402-1308

Mailing address

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 296-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100303000979 MS Practitioner - Nurse Practitioner 0345385282 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R852028MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Feb 23, 2011 Accepting new patients
Forrest County General Hospital CurrentSince Feb 1, 2020 Accepting new patients
RH Emergency Medicine of Pearl River LLC CurrentSince Jan 1, 2024 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest County General Hospital CurrentSince Feb 1, 2020 Accepting new patients
RH Emergency Medicine of Perry County LLC CurrentSince Feb 1, 2024 Accepting new patients
RH Emergency Medicine of Marion General LLC CurrentSince Jun 1, 2025 Accepting new patients
Pearl River County Hospital CurrentSince Feb 23, 2011 Accepting new patients
Forrest County General Hospital Past Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

305 W Moody St
Poplarville, MS 39470
Phone (601) 795-4345

305 W Moody St
#H
Poplarville, MS 39470
Phone (601) 795-4345

206 Bay Ave
Richton, MS 39476
Phone (601) 788-6316

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1881920817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-296-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-296-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIMON",
        "first_name": "BRIAN",
        "middle_name": "CARL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R852028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.