Individual provider Active NPI

Sandra K Holloway, MD

  • Gastroenterology Physician
  • Bend, OR
National Provider Identifier
1902898729
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD26430 Issued in OR
Practice address
2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone
(541) 706-4220
Fax
(541) 597-5819
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD26430 OR
Gastroenterology Physician 207RG0100X 0101043770 VA
Gastroenterology Physician 207RG0100X MD26430 OR Primary

Addresses

Primary practice location

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279

Mailing address

1247 NE Medical Center Dr
Bend, OR 97701-3786
Phone (541) 322-5753

Other practice location 1

1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone (541) 382-2811

Other identifiers 2

IdentifierTypeStateIssuer
00422280OtherORMEDICARE RAILROAD
271028MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sholloway27015@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060321000098 OR Practitioner - Internal MedicinePractitioner - Gastroenterology 9436055852 Reassigns benefits to 2 organizations
I20220128001219 TX Practitioner - Gastroenterology 9436055852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

2200 NE Neff Rd
Bend, OR 97701-4283
Phone (541) 382-4321

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy87
Upper gastrointestinal (GI) endoscopy for acid reflux72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101043770VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Ehg of Oregon PC Internal Medicine CurrentSince Dec 30, 2022 Accepting new patients
Ehg of Oregon PC Internal Medicine CurrentSince Dec 30, 2022 Accepting new patients
Ehg of Oregon PC Internal Medicine CurrentSince Jun 1, 2020 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 29, 2024 Accepting new patients
St. Charles Health System, Inc. Family Medicine CurrentSince Jul 29, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jan 19, 2022 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Internal Medicine Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

29358 Network Pl
Chicago, IL 60673

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

2200 NE Neff Rd
Bend, OR 97701
Phone (541) 322-2323

1715 SW Chandler Ave
Ste 100
Bend, OR 97702
Phone (541) 388-3006

2200 NE Neff Rd
Ste 302
Bend, OR 97701
Phone (541) 706-4220

1755 Coburg Rd
Unit 502
Eugene, OR 97401
Phone (458) 234-0082

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: sholloway27015@secure.stcharleshealthcare.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1902898729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013786",
            "telephone_number": "541-322-5753",
            "fax_number": "541-278-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 302",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014279",
            "telephone_number": "541-706-4220",
            "fax_number": "541-597-5819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 NE Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016051",
            "country_code": "US",
            "telephone_number": "541-382-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "SANDRA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD26430",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101043770",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD26430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "00422280",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271028",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sholloway27015@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 302",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.