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HOLLOWAY INTERNAL MEDICINE
NPI 1023908977
Internal Medicine in Cordele, GA

Active since July 03, 2025CLIA 11D2334597 · Waiver
415 E 4TH AVE STE B, CORDELE, GA 31015(229) 276-2190(229) 276-3639 Get Directions Write a Review

NPPES record last updated: July 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Holloway Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLOWAY INTERNAL MEDICINE (NPI 1023908977) is a healthcare organization registered as an internal medicine in Cordele, Georgia and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through November 23, 2027 and lists Kevin M Holloway, Organizer, as its authorized official.

NPPES Registry Identity

NPI1023908977
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameHOLLOWAY INTERNAL MEDICINE
Location Address415 E 4TH AVE STE BCordele, GA 31015-0614
Mailing Address1801 Quail RunCordele, GA 31015-2096
Phone(229) 276-2190
Fax(229) 276-3639
Organization SubpartNo
Authorized OfficialKevin M HollowayOrganizer · (229) 276-2190
Enumeration DateJuly 3, 2025
Last NPPES UpdateJuly 14, 2025
NPPES CertifiedJuly 14, 2025
✔ NPI 1023908977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
415 E 4TH AVE STE B, Cordele, GA 31015
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holloway Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Holloway Internal Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kevin Holloway, MD
Internal Medicine
NPI 1114107810
415 E 4TH AVE STE B
Cordele, GA 31015
(229) 276-2190
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2334597

Holloway Internal Medicine · Cordele, GA
Active · expires Nov 23, 2027
CLIA Number11D2334597
Laboratory TypePhysician Office
Certificate Effective DateNovember 24, 2025
Certificate Expiration DateNovember 23, 2027
Laboratory DirectorKevin M. Holloway
Laboratory Phone(229) 276-2190
Laboratory LocationHolloway Internal Medicine415 East 4th Avenue, Suite B, Cordele, GA 31015
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holloway Internal Medicine's NPI number?

The NPI number for Holloway Internal Medicine is 1023908977. It was assigned to this organization in the NPPES registry on July 3, 2025.

Where is Holloway Internal Medicine located?

Holloway Internal Medicine is located at 415 E 4th Ave Ste B, Cordele, GA 31015. The listed phone number is (229) 276-2190.

What is Holloway Internal Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Holloway Internal Medicine enrolled in Medicare?

Yes. Holloway Internal Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Holloway Internal Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Holloway Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Holloway Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2334597) is associated with this NPI, valid through November 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Holloway Internal Medicine was last updated on July 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.