Kelley Oralivia Holloway - Marshall

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

07001151A Issued in IN

Practice address

2003 W Fulton St Ste 303
Chicago, IL 60612-2345

Phone

(312) 243-2223

Fax

(312) 243-2227

NPI assigned

May 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

We Heel the Sole Podiatry LLCGroup PAC ID 0648579243, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.holloway.-.marshall.1@3342.direct.athenahealth.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.

• We Heel the Sole Podiatry LLC

  • Primary Podiatric Medicine Podiatrist
  • Indianapolis, IN
  • NPI 1457713406
  Medicare reassignment Care Compare group NPD
• MD @ Home Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415

  IN

  Medicare reassignment NPD
• Onhealthcare, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1417220369
  Medicare reassignment NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  Medicare reassignment
• Onhealthcare LLC

  • Social Worker
  • Indianapolis, IN
  • NPI 1114681681
  NPD
• Onhealthcare LLC

  • Podiatrist
  • Indianapolis, IN
  • NPI 1952677353
  NPD
• We Heel the Sole Podiatry LLC

  • Primary Podiatric Medicine Podiatrist
  • Memphis, TN
  • NPI 1558818666
  NPD
• Housecall Doctors PC

  • Podiatrist
  • Merrillville, IN
  • NPI 1407278377
  NPD (past)
• Osh-in Physicians Group, PC

  • Primary Care Clinic/Center
  • Indianapolis, IN
  • NPI 1073995338
  NPD (past)

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1942593231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-243-2223",
            "fax_number": "312-243-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-243-2223",
            "fax_number": "312-243-2227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Skokie Blvd Ste 520",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600621601",
            "country_code": "US",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOWAY - MARSHALL",
        "first_name": "KELLEY",
        "middle_name": "ORALIVIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005544",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001151A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048065",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01725310",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201168580",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01703698",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Hollis
• Anne Elizabeth Hollister, LCSW
• Hadyn Michael Hollister, M.D.
• Kristina Grace Hollkamp, PA-C
• Amy Cathleen Hollo
• Adlaide Holloway
• Calvin Holloway
• Janelle Holloway, MSW
• Lillian Frances Holloway, M.D.
• Melissa Holloway

• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.