KELLTON D'ANDRE DE'WAYNE HOLLINS — NPI 1093558884 (Licensed & Credentialed Case Manager/Care Coordinator in COALGATE, OK)

CMS-1500 Box 24J / 33a • NPI

1093558884

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171M00000X

Licensed & Credentialed Case Manager/Care Coordinator

Box 32 Service Location & ZIP+4

6 E LAFAYETTE AVE, COALGATE, OK, 74538-2676

✓ 9-Digit EDI 837 ZIP+4 (74538-2676)

Practice Phone & Referral Fax

(580) 927-3168

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1093558884 (KELLTON D'ANDRE DE'WAYNE HOLLINS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1093558884` (NPI-1 Individual Practitioner)
Provider / Legal Name	KELLTON D'ANDRE DE'WAYNE HOLLINS
Plain-English Specialty	Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: `171M00000X` (Case Manager/Care Coordinator)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6 E LAFAYETTE AVE, COALGATE, OK, 74538-2676
Practice Telephone / Fax	Tel: (580) 927-3168
Administrative Mailing Address	6 E LAFAYETTE AVE, COALGATE, OK, 74538-2676
Enumeration & Last Sync	Enumerated: 2024-06-18 \| CMS Record Updated: 2024-06-18

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6 E LAFAYETTE AVE, COALGATE, OK, 74538-2676

🗺️ Open in Google Maps 🏥 More Providers in COALGATE

🔒 Are you KELLTON D'ANDRE DE'WAYNE HOLLINS? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (171M00000X)

What Does Taxonomy Code 171M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Case Manager/Care Coordinator for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KELLTON D'ANDRE DE'WAYNE HOLLINS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171M00000X` — Case Manager/Care Coordinator Plain English: Licensed & Credentialed Case Manager/Care Coordinator	State: OK \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

KELLTON D'ANDRE DE'WAYNE HOLLINS (NPI #1093558884)