HOLLY ELIZABETH GOODMAN (NP) – Acute Care Nurse Practitioner, NPI 1104497957

HOLLY ELIZABETH GOODMAN (NP) is a healthcare provider. based in Lizella, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN264268 (GA). The NPI Number for HOLLY ELIZABETH GOODMAN (NP) is 1104497957

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY ELIZABETH GOODMAN (NP)
NPI
1104497957
Phone
(478) 550-0605
Address
6264 ROGERS RD
Enumeration Date
2 July 2021
Last Update Date
2 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4782723525
Graduation Year
2021 (5 years ago)
PAC ID
3072915008
Group Practice PAC ID
7810985645
Professional Enrollment ID
I20210713001467
Address ID
GA310212560DU206XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for HOLLY ELIZABETH GOODMAN (NP)

  • 6264 ROGERS RD

    LIZELLA, GA 310525503

    Phone: (478) 550-0605

    Type: Mailing

  • 2064 VINEVILLE AVE

    MACON, GA 312043140

    Phone: (478) 743-1478

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 87 Open Payments records for all available years, with a total value of $2,299.

Total Amount is formed as General ($2,299) + Research ($0) + Ownership ($0) = $2,299.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($393).

Total Amount

$2,299

General + Research + Ownership

Payments

87

Total payment records

General Amount

$2,299

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2021-07-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210713001467INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes270244$0
99213Established patient office or other outpatient visit, 20-29 minutes231185$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes17880$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report159153$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes3732$0
View full utilization report →

Insurance plans in this area (ZIP 31052)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810985645View full group profile
NameSpecialtyState
Nurse PractitionerGA
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal MedicineGA
-GA
Interventional Cardiology, Cardiovascular Disease (Cardiology)GA
Nurse PractitionerGA
-GA

Reviews

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Frequently asked questions

What unique ID ties claims to HOLLY ELIZABETH GOODMAN (NP)?
NPI 1104497957 is assigned to HOLLY ELIZABETH GOODMAN (NP) under the national enumeration system.
Is HOLLY ELIZABETH GOODMAN (NP)'s NPI currently valid?
The extract we use shows HOLLY ELIZABETH GOODMAN (NP) as active.
Can you summarize HOLLY ELIZABETH GOODMAN (NP)'s specialty in plain language?
Clinically, the directory lists HOLLY ELIZABETH GOODMAN (NP) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is HOLLY ELIZABETH GOODMAN (NP)'s primary listing?
We display Lizella, Georgia because that is what the record indicates for HOLLY ELIZABETH GOODMAN (NP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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