Individual provider Active NPI

Karie Margaret Holldorf, NP

  • Family Nurse Practitioner
  • Smyrna, TN
National Provider Identifier
1902104300
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18578 Issued in TN
Practice address
14299 Old Nashville Hwy
Smyrna, TN 37167-6315
Phone
(847) 530-4748
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209004397 IL
Family Nurse Practitioner 363LF0000X 18578 TN Primary

Addresses

Primary practice location

14299 Old Nashville Hwy
Smyrna, TN 37167-6315

Mailing address

2040 Woodcliff Dr
Smyrna, TN 37167-5894
Phone (847) 530-4748

Other names 1

  • Mrs. Karie Margaret Banach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004397ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1902104300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WOODCLIFF DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675894",
            "telephone_number": "847-530-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14299 OLD NASHVILLE HWY",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676315",
            "telephone_number": "847-530-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLDORF",
        "first_name": "KARIE",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004397",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARIE",
            "last_name": "BANACH",
            "middle_name": "MARGARET",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.