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DR. KELLI LEA HOLLOWAY M.D.
NPI 1548408206
Counselor - Professional in Portland, OR

Active since February 03, 2009Opted out of Medicare · through Apr 1, 2027
4800 SW MACADAM AVENUE, SUITE 325, PORTLAND, OR 97239(503) 295-7900(503) 224-8883 Get Directions Write a Review

NPPES record last updated: February 3, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kelli Lea Holloway M.d. NPPES

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

DR. KELLI LEA HOLLOWAY M.D. (NPI 1548408206) is an individual professional provider in Portland, Oregon, licensed in Oregon (MD23361) and active in the NPI registry since February 2009. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1548408206
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDR. KELLI LEA HOLLOWAYCredential: M.D.
Location Address4800 SW MACADAM AVENUE, SUITE 325Portland, OR 97239-3927
Mailing Address4800 S.w. Macadam Avenue, Suite 325Portland, OR 97239-3927 · (503) 295-7900 · Fax (503) 224-8883
Phone(503) 295-7900
Fax(503) 224-8883
Sole ProprietorYes
Enumeration DateFebruary 3, 2009
✔ NPI 1548408206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · MD23361
4800 SW MACADAM AVENUE, Portland, OR 97239
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kelli Lea Holloway M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2015 through April 1, 2027.

Opt-Out Effective DateApril 1, 2015
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Kelli Holloway's NPI number?

The NPI number for Kelli Holloway is 1548408206. It was assigned to this individual provider in the NPPES registry on February 3, 2009.

Where is Kelli Holloway located?

Kelli Holloway practices at 4800 SW Macadam Avenue Suite 325, Portland, OR 97239. The listed phone number is (503) 295-7900.

What is Kelli Holloway's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kelli Holloway enrolled in Medicare?

No. Kelli Holloway has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kelli Holloway was last updated on February 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.