1376577767 NPI number — HOLLY A ROBINSON M.D.

Table of content: HOLLY A ROBINSON M.D. (NPI 1376577767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376577767 NPI number — HOLLY A ROBINSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
HOLLY
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SILLINGS
Provider Other First Name:
HOLLY
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376577767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1026
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46206-1026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-777-6435
Provider Business Mailing Address Fax Number:
317-777-6644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 RILEY HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202-5109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-274-2617
Provider Business Practice Location Address Fax Number:
317-278-2587
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  01049246 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2439627000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 370016392 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700254 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64015860 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1161921 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200257520A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000174336 . This is a "ANTHEM BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 1161921 . This is a "PASSPORT KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 410029P . This is a "SIHO" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 7518123 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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