MR. CHARLES W HOLLOWAY (PA-C) – Medical Physician Assistant, NPI 1063784676
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for MR. CHARLES W HOLLOWAY (PA-C)
346 DEEP SOUTH FARM RD STE A
BLAIRSVILLE, GA 305122218
Phone: (706) 745-9417
Fax: (706) 896-0877
Type: Location
56 Hospital St
Hiawassee, GA 305463251
Phone: (706) 896-7858
Fax: (706) 896-0877
Type: Location
4799 Blue Ridge Dr Ste 104
Blue Ridge, GA 305133468
Phone: (706) 632-1155
Fax: (706) 896-0877
Type: Location
1775 ACCESS RD STE C
COVINGTON, GA 300141987
Phone: (770) 255-0123
Fax: (770) 255-0123
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141111001558 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30512)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | PA | |
| Family Practice, Obstetrics/Gynecology, Pediatric Medicine | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | GA | |
| Family Practice | GA |
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