Renee Kathleen Holley, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002132A Issued in IN

Practice address

7222 Engle Road
Fort Wayne, IN 46804-2222

Phone

(260) 432-5005

Fax

(260) 432-6003

NPI assigned

Dec 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Renee Kathleen Conner Rogers Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergy and Asthma Center, PCGroup PAC ID 4587567391, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101
• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

Merit-based Incentive Payment System (MIPS)

Final score

91.95 of 100Reported as group

Quality

100

Improvement activities

40

Cost

73.17

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: holley.renee.018.0140061@aac.meditab.direct-ci.com

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.

• Allergy & Asthma Center, PC

  • Allergy & Immunology Physician
  • Fort Wayne, IN
  • NPI 1386606911
  Medicare reassignment Care Compare group NPD
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD

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

• Warsaw Health System LLC

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation
• Whitley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Columbia City, IN
  • NPI 1205844495
  Care Compare affiliation
• Whitley Memorial Hospital, Inc.

  • Land Ambulance
  • Columbia City, IN
  • NPI 1497764450

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1932383254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7222 ENGLE ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042222",
            "telephone_number": "260-432-5005",
            "fax_number": "260-432-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7222 ENGLE ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042222",
            "telephone_number": "260-432-5005",
            "fax_number": "260-432-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "RENEE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002132A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20088850",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00689114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "ROGERS",
            "middle_name": "KATHLEEN CONNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith Holland
• Rylee Holland
• Kendra Jean Hollenbeck, MD
• Joshua Ryan Holley, FNP-BC
• Malyssa L Holley, RBT
• Amber N Hollins, COTA
• Amelia Marie Holloway, PHARMD
• Patrick M. Holly, MD
• Michael Holmes, LAT, ATC
• Ryan K Holmes, D.D.S.

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.