HOLLY JOHNSON LTC, PLLC (NPI# 1114426756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114426756 |
| Entity Type | Organization |
| Organization Name | HOLLY JOHNSON LTC, PLLC |
| Practice Address |
5505 New Copeland Rd Tyler TX 75703-3955 |
| Mailing Address |
608 Monroe St Jacksonville TX 75766-4342 |
| Practice Telephone | 9037050202 |
| Mailing Telephone | 9037210865 |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2019-06-14 |
| Authorized Official Name | HOLLY M AUGUSTUS (OWNER/EMPLOYEE) |
| Authorized Official Telephone | 9037210865 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP136353 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5505 NEW COPELAND RD |
| City | TYLER |
| State | TX |
| Zip Code | 75703-3955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538372966 | Kimberly Ann Testa | Physical Therapist | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2007-05-08 |
| 1922640879 | Rodney Smiley | Nurse Practitioner | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2019-10-11 |
| 1629550199 | Cathy Marie Wise | Physical Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-31 |
| 1174005607 | Kathryn Hope Johnson | Occupational Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-31 |
| 1720560139 | Stephen Greene | Occupational Therapist | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-31 |
| 1972085520 | Mary E Henson | Physical Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-30 |
| 1871075440 | Dayna Graves | Occupational Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-30 |
| 1194206987 | Susan Dailey | Occupational Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-28 |
| 1174004329 | Jennifer M Washington | Physical Therapy Assistant | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-26 |
| 1487135125 | Chona Labrador | Physical Therapist | 5505 New Copeland Rd, Tyler, TX 75703-3955 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174084024 | Branden Blanton | Nurse Practitioner | 708 Bentley Ct, Tyler, TX 75703-4621 | 2019-03-25 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1821499682 | Fraquania Talesh Freeman | Nurse Practitioner | 505 S Fleishel Ave, Tyler, TX 75702-8413 | 2014-09-11 |
| 1366841942 | Robin Villena | Nurse Practitioner | 1910 Roseland Blvd, Tyler, TX 75701-4246 | 2014-08-19 |
| 1013325638 | Rendall Northcutt | Nurse Practitioner | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2014-07-28 |
| 1760791370 | Shari Renea Howard | Nurse Practitioner | 1910 Roseland Blvd, Tyler, TX 75701 | 2010-09-29 |
| 1457561615 | Brian Wallace | Nurse Practitioner | 1910 Roseland Blvd, Tyler, TX 75701-4246 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740588 | Jessica Claudia Cazaubon | Nurse Practitioner | 13327 Crim Rd, Houston, TX 77049-3448 | 2020-11-04 |
| 1629679147 | Magdoleen Awad | Nurse Practitioner | 1602 Morning Dove Ct, Carrollton, TX 75007-1462 | 2020-11-02 |
| 1215536131 | Linnet Litakuli Nandwa | Nurse Practitioner | 6509 Sheerwater Rd, Arlington, TX 76002-3680 | 2020-10-21 |
| 1902405301 | Texas Suburban Visiting Physician Services | Nurse Practitioner | 2200 Smith Barry Rd, Pantego, TX 76013-5800 | 2020-10-19 |
| 1437757432 | Katie Jo Dixon | Nurse Practitioner | 4300 Speedway Unit 4775, Austin, TX 78765-2032 | 2020-10-12 |
| 1376140954 | Melissa Kujawski | Nurse Practitioner | 332 Enid Dr, Lewisville, TX 75056-5874 | 2020-10-06 |
| 1952908188 | Sari Alhaik | Nurse Practitioner | 411 Park Grove Dr Ste 620, Katy, TX 77450-1576 | 2020-10-01 |
| 1669089421 | Heather Ann Votion | Nurse Practitioner | 4501 S General Bruce Dr Ste 75, Temple, TX 76502-1466 | 2020-09-25 |
| 1245847318 | Xin Peng | Nurse Practitioner | 707 Walsh Hill Trl, Cedar Park, TX 78613-4855 | 2020-09-23 |
| 1194331470 | Clara Dornisha Green | Nurse Practitioner | 5847 Acacia Cir Apt 1816, El Paso, TX 79912-4881 | 2020-09-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.