Holly Hullett Roy, PA-C
Individual provider Active NPI Physician Assistant · Moneta, VA
NPI 1972874394 · NPPES record last updated Dec 29, 2025
Key facts
- NPI
- 1972874394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110003769 (VA)
- Practice address
- 14807 Moneta Rd Ste J
Moneta, VA 24121-6449 - Phone
- (540) 703-2682
- Fax
- (540) 698-1030
- NPI assigned
- Jan 17, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Jefferson Medical College of Thomas Jefferson University, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Rehabilitation, LLC
Practice addresses (Care Compare)
14807 Moneta Rd
Suite J
Moneta, VA 24121-6449
Phone (540) 580-1624
2600 Compass Rd
Glenview, IL 60026-8001
Hospital & facility affiliations
- Carilion Medical Center
- Centra Bedford Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, NC
- 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 |
|---|---|---|---|---|
| I20120501000395 | VA | Practitioner - Physician Assistant | 6507028982 | Reassigns benefits to 6 organizations |
| I20221217000154 | NC | Practitioner - Physician Assistant | 6507028982 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pai Participant 29, P.C. | Current |
Accepting new patients | |
| Eventus WH PLLC Care, LLC | Current |
Accepting new patients | |
| Premier Psychiatric Solutions PLLC | Past |
Accepting new patients |
Locations
710 Julian Rd
Salisbury, NC 28147
Phone (704) 636-5812
158 Chestnut Grove Church Rd
Sparta, NC 28675
Phone (336) 429-5934
999 Waterside Dr
Ste 2525
Norfolk, VA 23510
Phone (757) 777-3787
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110003769 | VA | Yes |
Addresses
Primary practice location
14807 Moneta Rd Ste J
Moneta, VA 24121-6449
Mailing address
14807 Moneta Rd Ste J
Moneta, VA 24121-6449
Phone (540) 703-2682
Other providers in Moneta, VA
- Sherry Ann Ray
- Regal Medical Services, LTD
- Rodyhill Healthcare Solutions, LTD.
- Brian David Rogers
- Cheryl A Romeo
- James Andrew Schaible
- Vishal Shah
- Linda Marlene Shaner
- Carol A Sharp
- Bryan G. Sicher
All providers in Moneta, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2025. 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.