HOLLY BERRYMAN BACKE (NPI# 1275166175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275166175 |
| Entity Type | Individual |
| Full Name | HOLLY BERRYMAN BACKE |
| Credential | CRNP |
| Practice Address |
1216 Somerville Rd Se Decatur AL 35601-4335 |
| Mailing Address |
2301 Dogwood Ln Se Decatur AL 35601-5317 |
| Practice Telephone | 2563400012 |
| Practice Fax Number | 2563401408 |
| Mailing Telephone | 2564762295 |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-03-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1-139307 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1216 SOMERVILLE RD SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144301243 | Home Dialysis of North Alabama Inc. | Internal Medicine | 1216 Somerville Rd Se, Decatur, AL 35601-4335 | 2006-10-17 |
| 1730712738 | North Alabama Home Dialysis | Clinic/Center | 1216 Somerville Rd Se, Decatur, AL 35601-4335 | 2020-02-18 |
| 1629621362 | Stacey Dunn Ethridge | Dietitian, Registered | 1216 Somerville Rd Se, Decatur, AL 35601-4335 | 2019-07-22 |
| 1194137653 | Avra Ratliff Adair | Nurse Practitioner | 1216 Somerville Rd Se, Decatur, AL 35601-4335 | 2014-06-02 |
| 1891960175 | Constance Marie Schneider | Nurse Practitioner | 1216 Somerville Rd Se, Decatur, AL 35601-4335 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686062 | Tara Cooley | Nurse Practitioner | 909 Tracey Ln, Decatur, AL 35601-7701 | 2020-03-30 |
| 1407489479 | Marathon Health LLC | Nurse Practitioner | 152 Ipsco St, Decatur, AL 35601-7412 | 2020-02-19 |
| 1518502475 | Marissa Lynne Henderson | Nurse Practitioner | 609 Medical Center Dr Ste 2700, Decatur, TX 76234-3839 | 2019-11-14 |
| 1912463456 | Kimberly S Williams | Nurse Practitioner | 4565 Riverwood Cir, Decatur, GA 30035-2935 | 2019-02-20 |
| 1164907242 | Megan Skelley | Nurse Practitioner | 487 Winn Way Ste 202, Decatur, GA 30030-1728 | 2018-09-25 |
| 1508359969 | Rebecca A Voyles | Nurse Practitioner | 575 W Hay St, Decatur, IL 62526-4164 | 2018-06-11 |
| 1598278558 | Vera Mahou | Nurse Practitioner | 4150 Snapfinger Woods Dr Ste 120, Decatur, GA 30035-3417 | 2017-11-13 |
| 1346753738 | Alexis Renee Graven | Nurse Practitioner | 2300 N Edward St Ste 2400, Decatur, IL 62526-4163 | 2017-11-08 |
| 1508240409 | Zachary Pitts | Nurse Practitioner | 2606 Woodridge Dr, Decatur, GA 30033-4835 | 2015-07-10 |
| 1891063095 | Alexis E. Daugherty | Nurse Practitioner | 603 Church St, Decatur, GA 30030-2517 | 2011-12-02 |
| Find all providers in DECATUR | ||||
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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.