Individual provider Active NPI

Micahl Holloway, APRN

  • Family Nurse Practitioner
  • Gary, IN
National Provider Identifier
1942957535
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28199983A Issued in IN
Practice address
7201 W 25TH Ave
Gary, IN 46406-2940
Phone
(219) 979-2026
NPI assigned
Mar 3, 2022
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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 71012573A IN
Family Nurse Practitioner 363LF0000X 28199983A IN Primary

Addresses

Primary practice location

7201 W 25TH Ave
Gary, IN 46406-2940

Mailing address

7201 W 25TH Ave
Gary, IN 46406-2940
Phone (219) 979-2026

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220628000266 IN Practitioner - Nurse Practitioner 3971982588 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Altea Medical Indiana PCGroup PAC ID 4183064389, 24 clinicians
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

2350 Taft St
Gary, IN 46404-3349
Phone (219) 977-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28199983AINMDFamily Nurse Practitioner
71012573AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Post Acute Care PLLC CurrentSince Jun 6, 2022 Accepting new patients
Altea Medical Indiana PC CurrentSince Feb 26, 2024 Accepting new patients
Sound Physicians of Indiana, LLC CurrentSince Feb 1, 2023 Accepting new patients
Post Acute Medical PLLC CurrentSince Jan 21, 2024 Accepting new patients
Sound Physicians of Indiana, LLC CurrentSince Feb 1, 2023 Accepting new patients
Sound Physicians of Indiana, LLC Current Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437

2350 Taft St
Gary, IN 46404
Phone (219) 944-2677

4410 W 49th Ave
Hobart, IN 46342
Phone (219) 942-3279

3518 S Lafountain St
#3803
Kokomo, IN 46902
Phone (765) 453-4667

1101 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 874-5211

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1942957535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 W 25TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464062940",
            "telephone_number": "219-979-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 W 25TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464062940",
            "telephone_number": "219-979-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "MICAHL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012573A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28199983A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.