Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Holloway, FNP-C

Individual provider Nurse Practitioner · NPI 1821534231

Shane Holloway, FNP-C is a Nurse Practitioner in Columbia, Missouri. Qualified in 2016, 10 years ago. Practices with Renova Medical Center LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
10
Licensed in
MO
In the registry since
2017
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

1401 Forum Blvd Ste 202
Columbia, MO 65203-1915
Phone: (573) 234-1367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2016044506 (MO)

Record details

NPI number1821534231
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJanuary 9, 2017
Last updated in NPPESDecember 15, 2022
Certification dateDecember 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Renova Medical Center Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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