Individual provider Active NPI

Anthony Theodore Hollifield Jr., APRN

  • Family Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1891058269
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN197148 Issued in GA
Practice address
2122 Manchester Expy
Columbus, GA 31904-6878
Phone
(706) 596-4000
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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 RN197148 GA Primary

Addresses

Primary practice location

2122 Manchester Expy
Columbus, GA 31904-6878

Mailing address

2122 Manchester Expy
Columbus, GA 31904-6878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130725000691 GA Practitioner - Nurse Practitioner 9830330331 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN197148GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Columbus, LLC CurrentSince Aug 1, 2018 Accepting new patients
Inphynet Primary Care Physicians Southeast PC CurrentSince Jan 1, 2016 Accepting new patients
Heritage Physician Services, LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1891058269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046878",
            "telephone_number": "706-596-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIFIELD",
        "first_name": "ANTHONY",
        "middle_name": "THEODORE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN197148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.