NPIMap

Individual provider Active NPI

Andria Holmes Holt, RN

  • Obstetrics & Gynecology Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1023500188
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
4924227-4405 Issued in UT
Practice address
30 N 1900 E
Salt Lake City, UT 84132
Phone
(801) 581-7647
NPI assigned
Jun 5, 2018
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
High-Risk Obstetric Registered Nurse 163WX0002X 4924227-3102 UT
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 4924227-4405 UT Primary

Addresses

Primary practice location

30 N 1900 E
Salt Lake City, UT 84132

Mailing address

8916 S Flatiron Dr
Sandy, UT 84093-1704
Phone (801) 560-5480

Other names 1

  • Andria Lyn Holmes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aholt291443@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180921002793 UT Practitioner - Nurse Practitioner 1557612058 Reassigns benefits to 2 organizations
I20260415002848 NV Practitioner - Nurse Practitioner 1557612058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Specialty ServicesGroup PAC ID 2961726831, shared by 2 NPIs, 94 clinicians

Practice addresses (Care Compare)

247 Bluffs Ave
Suite 102
Elko, NV 89801-2488
Phone (775) 738-1212

50 N Medical Dr
U of U Department of OB/GYN Gynecol
Salt Lake City, UT 84132-0100
Phone (801) 587-6336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
45.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4924227-4405UTMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Specialty Services Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Specialty Services CurrentSince Jul 15, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Jul 15, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Jul 15, 2018 Accepting new patients
University of Utah Specialty Services CurrentSince Jul 15, 2018 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
University of Utah Specialty Services Past Accepting new patients

Locations

247 Bluffs Ave
Ste 102
Elko, NV 89801
Phone (775) 369-2799

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

50 N Medical Dr
#U
Salt Lake Cty, UT 84132
Phone (801) 581-4314

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

555 Foothill Dr
Slc, UT 84112
Phone (801) 581-7589

Interoperability endpoints

  • Direct secure messaging: aholt291443@direct.med.utah.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1023500188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8916 S FLATIRON DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931704",
            "telephone_number": "801-560-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-581-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "ANDRIA",
        "middle_name": "HOLMES",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, High-Risk",
            "state": "UT",
            "license": "4924227-3102",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "UT",
            "license": "4924227-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aholt291443@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDRIA",
            "last_name": "HOLMES",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.