HOLLY ANN WOLTERS (NPI# 1104197318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104197318 |
| Entity Type | Individual |
| Full Name | HOLLY ANN WOLTERS |
| Other Name | HOLLY ANN FORTKAMP |
| Credential | P.A. |
| Practice Address |
4160 Little York Rd Suite 10 Dayton OH 45414-5800 |
| Mailing Address |
Po Box 713130 Cincinnati OH 45271-0001 |
| Practice Telephone | 9374159100 |
| Practice Fax Number | 9374159191 |
| Mailing Telephone | 9374159100 |
| Mailing Fax Number | 9374159191 |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2013-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50.003461 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0071994 | 05 | |
| OH | RR MEDICARE | P01170703 | 01 |
| Street Address |
4160 LITTLE YORK RD SUITE 10 |
| City | DAYTON |
| State | OH |
| Zip Code | 45414-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598764391 | Cardiology Specialists of Dayton Inc. | Internal Medicine | 4160 Little York Rd, Ste. 20, Dayton, OH 45414-5800 | 2005-07-14 |
| 1538532825 | Amy Birkemeier | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-11-09 |
| 1154701837 | Zachary Baum | Registered Nurse | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-06-08 |
| 1578942728 | Rachel Lloyd | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-05-20 |
| 1508267279 | Lauren Rode | Physician Assistant | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2014-09-11 |
| 1194149955 | Kathleen Walker | Occupational Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2014-02-13 |
| 1821338336 | Jcc, LLC | Clinic/Center | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2013-02-20 |
| 1053661926 | Stephanie Jae Buehler | Occupational Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2012-09-18 |
| 1598047664 | Brigitte Nicole Eric | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2011-09-15 |
| 1255613568 | Alliance Physician Inc | Internal Medicine | 4160 Little York Rd, Suite 20, Dayton, OH 45414-5803 | 2011-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578047916 | Amanda Adkins | Counselor | 4977 Northcutt Pl, Dayton, OH 45414 | 2018-09-21 |
| 1477062180 | Andria Shoebridge | Case Manager/Care Coordinator | 7695 Poe Ave., Dayton, OH 45414 | 2017-09-26 |
| 1164826871 | Joana's | Custodial Care Facility | 323 Timberlake Drive, Dayton, OH 45414 | 2014-10-09 |
| 1376956839 | Shanata Rankins | Home Health Aide | 3252 Ridge Ave, Dayton, OH 45414 | 2014-06-03 |
| 1689086845 | Michelle Laree Cargle-adams | Licensed Practical Nurse | 6217 Miller Lane, Vandalia, OH 45414 | 2014-05-22 |
| 1962847236 | Tessa Skeens | Home Health | 1914 Palisades Dr, Dayton, OH 45414 | 2013-05-01 |
| 1053661397 | Jeffrey Michael Pope | Pharmacist | 3700 North Dixie Highway, Dayton, OH 45414 | 2012-09-13 |
| 1174871784 | Elizabeth Long | Counselor | 3821 Little York Rd., Dayton, OH 45414 | 2012-08-29 |
| 1265709885 | Eddie Dudley | Pharmacist | 5651 Dixie Ave, Dayton, OH 45414 | 2011-11-28 |
| 1568774743 | Martin Nicholas Kanetsky | Dentist | 6800 N. Dixie Dr., Dayton, OH 45414 | 2010-07-05 |
| Find all providers in zip 45414 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091241 | Beau Webb | Physician Assistant | 6017 Cruxten Dr, Dayton, OH 45424-3702 | 2020-10-18 |
| 1043838782 | Marie Therese Mualla Oram | Physician Assistant | 204 Sears St Apt 518, Dayton, OH 45402-1573 | 2020-07-09 |
| 1720542509 | Herodina Ibanez Lu | Physician Assistant | 1 Elizabeth Pl Nwb Ste 15, Dayton, OH 45417-3445 | 2019-01-25 |
| 1427585819 | Mita Morar | Physician Assistant | 938 Olde Sterling Way, Dayton, OH 45459-3100 | 2017-05-16 |
| 1306394275 | Danielle Elizabeth Tirjer Cleary | Physician Assistant | 320 Judith Dr, Dayton, OH 45429-5306 | 2016-09-20 |
| 1831555234 | Lisa Byers | Physician Assistant | 7980 N Main St, Dayton, OH 45415-2328 | 2016-01-14 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1104201730 | Dominique Hunt | Physician Assistant | 5300 Far Hills Ave Ste 300, Dayton, OH 45429-2381 | 2015-07-24 |
| 1285025957 | Holly Griffin | Physician Assistant | 4340 Clyo Rd, Dayton, OH 45459-7000 | 2015-02-16 |
| 1073885216 | Shawn Breeding | Physician Assistant | 627 Edwin C. Moses Blvd, Suite K, Dayton, OH 45417-3474 | 2012-02-03 |
| Find all providers in DAYTON | ||||
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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.