HOLLEY V. HAGAN NP-C
NPI 1962653386
Nurse Practitioner in Carrollton, GA

Q: What is Holley Hagan's NPI number?

The NPI number for Holley Hagan is 1962653386. It was assigned to this individual provider in the NPPES registry on October 3, 2008.

Q: What is Holley Hagan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Holley Hagan was last updated on October 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since October 03, 2008PECOS Enrolled

100 PROFESSIONAL PARK, SUITE 202, CARROLLTON, GA 30117(770) 832-6861(770) 832-9432 Get Directions Write a Review

NPPES record last updated: October 3, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Holley V. Hagan Np-c NPPES

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

HOLLEY V. HAGAN NP-C (NPI 1962653386) is an individual nurse practitioner in Carrollton, Georgia, licensed in Georgia (RN131149NP) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962653386

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameHOLLEY V. HAGANCredential: NP-C

Location Address100 PROFESSIONAL PARK, SUITE 202Carrollton, GA 30117

Mailing Address100 Professional Park, Suite 202Carrollton, GA 30117 · (770) 832-6861 · Fax (770) 832-9432

Phone(770) 832-6861

Fax(770) 832-9432

Sole ProprietorNo

Enumeration DateOctober 3, 2008

✔ NPI 1962653386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in GA · RN131149NP

Definition

(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.

100 PROFESSIONAL PARK, Carrollton, GA 30117

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holley V. Hagan Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Holley Hagan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Privia Medical Group Of Georgia LLC

35 mi

Internal Medicine

101 YORKTOWN DR
Fayetteville, GA 30214

Reassigned Medicare billing, Georgia enrollment
759 clinicians in this Medicare group

NPI 1013313857 (770) 460-4285

Community Care Health Network LLC

203 mi

Nurse Practitioner

424 CHURCH ST STE 220
Nashville, TN 37219

Reassigned Medicare billing, Georgia enrollment
274 clinicians in this Medicare group

NPI 1619368842 (877) 564-3627

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. SHAWN R SKALIN ED.S., LPC.

Counselor (Professional)

100 PROFESSIONAL PARK, SUITE 302
CARROLLTON, GA 30117

Carroll County (770) 830-1300

DR. HERMOGENES PAGSISIHAN M.D.

Family Medicine

100 PROFESSIONAL PARK, SUITE 204
CARROLLTON, GA 30117

Carroll County (770) 834-3351

ALEXANDER MESKI MD

Psychiatry & Neurology (Psychiatry)

100 PROFESSIONAL PARK, SUITE 301
CARROLLTON, GA 30117

Carroll County (770) 214-2300

CHARLES HOYT DAVIS III MD

Family Medicine

100 PROFESSIONAL PARK, SUITE 202
CARROLLTON, GA 30117

Carroll County (770) 832-6861

LINDSEY BASKIN ROENIGK MD

Internal Medicine (Pulmonary Disease)

100 PROFESSIONAL PARK, SUITE 204
CARROLLTON, GA 30117

Carroll County (770) 834-3351

JEFFREY S. REID M.D.

Internal Medicine (Pulmonary Disease)

100 PROFESSIONAL PARK, SUITE 204
CARROLLTON, GA 30117

Carroll County (770) 834-3351

MS. JEANETTE L BROYLES LPC

Counselor

100 PROFESSIONAL PARK, STE 302
CARROLLTON, GA 30117

Carroll County (770) 830-1300

DR. JOSEPH JELLICORSE M.D.

Family Medicine

100 PROFESSIONAL PARK, SUITE 204
CARROLLTON, GA 30117

Carroll County (770) 834-3351

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 Holley Hagan's NPI number?

The NPI number for Holley Hagan is 1962653386. It was assigned to this individual provider in the NPPES registry on October 3, 2008.

Where is Holley Hagan located?

Holley Hagan practices at 100 Professional Park Suite 202, Carrollton, GA 30117. The listed phone number is (770) 832-6861.

What is Holley Hagan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Holley Hagan enrolled in Medicare?

Yes. Holley Hagan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Holley Hagan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holley Hagan reassigns Medicare benefits to 2 organizations: Privia Medical Group Of Georgia LLC (Fayetteville, GA) and Community Care Health Network LLC (Nashville, TN). Each 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 Holley Hagan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Holley Hagan was last updated on October 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.