Holly J Beene, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Colorado Springs, CO
NPI 1962089383 · NPPES record last updated Apr 23, 2021
Key facts
- NPI
- 1962089383
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 0996390 (CO)
- Practice address
- 807 Point of the Pines Dr
Colorado Springs, CO 80919-8141 - Phone
- (575) 491-2011
- NPI assigned
- Mar 24, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mellow Medical Inc a Professional Corporation
Practice addresses (Care Compare)
12301 Wilshire Blvd
Suite 512
Los Angeles, CA 90025-1053
Phone (888) 684-2779
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221116002883 | CA | Practitioner - Nurse Practitioner | 4284002650 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0996390 | CO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mellow Medical Inc a Professional Corporation | Psychiatry | Current |
Accepting new patients |
Locations
12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284
Interoperability endpoints
- holly.beene.2@9357.direct.athenahealth.com
- https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4
- holly.beene.3@9357.direct.athenahealth.com
- holly.beene.1@9357.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0996390 | CO | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0996390 | CO | Yes |
Addresses
Primary practice location
807 Point of the Pines Dr
Colorado Springs, CO 80919-8141
Mailing address
807 Point of the Pines Dr
Colorado Springs, CO 80919-8141
Phone (575) 491-2011
Other providers in Colorado Springs, CO
- David Allen Beebe
- Isabelle Therese Beebe
- Samantha Beemer
- Sarah Beemon-Grant
- Kristi A. Been
- Karen Beers
- Katelyn Beevers
- Beewell Assisted Living LLC
- Abbagale Beggs
- Martin Lynn Beggs
All providers in Colorado Springs, CO · Psychiatric/Mental Health Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.