Individual provider Active NPI

Anna Holland, CRNP

  • Family Nurse Practitioner
  • Hartselle, AL
National Provider Identifier
1962740126
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-118196 Issued in AL
Practice address
615 Mynatt St SW
Hartselle, AL 35640-2877
Phone
(256) 773-2979
Fax
(256) 773-2986
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-118196 AL Primary

Addresses

Primary practice location

615 Mynatt St SW
Hartselle, AL 35640-2877

Mailing address

615 Mynatt St SW Ste E
Hartselle, AL 35640-2878
Phone (567) 732-9792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20130820000218 AL Practitioner - Nurse Practitioner 3870735905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartselle Family MedicineGroup PAC ID 5395765762, 5 clinicians

Practice addresses (Care Compare)

615 Mynatt St SW
Suite E
Hartselle, AL 35640-2878
Phone (256) 773-2979

Hospital & facility affiliations

  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartselle Family Medicine CurrentSince Sep 4, 2018 Accepting new patients

Locations

615 Mynatt St SW
Ste E
Hartselle, AL 35640
Phone (256) 773-2979

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1962740126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MYNATT ST SW STE E",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402878",
            "telephone_number": "567-732-9792",
            "fax_number": "256-773-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MYNATT ST SW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402877",
            "telephone_number": "256-773-2979",
            "fax_number": "256-773-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-118196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartselle, AL

Sources for this page

Verify at the official NPI Registry.