Holly Fitzwater, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

104002 Issued in WV

Practice address

10003 Webster Rd
Camden on Gauley, WV 26208-7713

Phone

(304) 226-5725

NPI assigned

Jul 18, 2019

Last updated

Feb 23, 2021By the provider in NPPES

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 names 1

• Holly Ruth Fain Former name

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Nettie, WV
  • NPI 1174065916
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health-Red Oak

  • Federally Qualified Health Center (FQHC)
  • Craigsville, WV
  • NPI 1215394648
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1245938513
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Craigsville, WV
  • NPI 1427585157
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1508372228
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1558174086
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Central WV Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1558340414
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1700312618
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Ansted, WV
  • NPI 1801493499
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc

  dba Camden Family Health (lewis)

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1861872541
  Medicare reassignment NPD
• Camden on Gauley Medical Center Inc.

  dba Camden Family Health

  • Federally Qualified Health Center (FQHC)
  • Richwood, WV
  • NPI 1811420250
  Medicare reassignment NPD
• Camden on Gauley Medical Center, Inc

  dba Camden Family Health (Cowen Location)

  • Federally Qualified Health Center (FQHC)
  • Cowen, WV
  • NPI 1639418361
  Medicare reassignment NPD

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1932752078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "HOLLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "FAIN",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Susan Clagg, D.O.
• Elizabeth Ann Coffman, FNP-BC
• Stephanie Cool
• Hannah Dorsey
• Jennifer Rose Durham, APN
• Heather Dawn Glasko-Tully, MSN, APRN, NP-C, FNP
• Jennifer Hall, MSW, LICSW
• Mark J Hardway, M.D.
• Lisa Ellen Henthorn, LPC, NCC
• Crystal Marie Hickman Rodebaugh, MD

• Family Nurse Practitioner in Camden on Gauley, WV
• Providers in Camden on Gauley, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.