Individual provider Active NPI

Ryan Holt, FNP-C

  • Family Nurse Practitioner
  • Auburn, CA
National Provider Identifier
1043030455
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032552 Issued in CA
Practice address
13555 Bowman Rd Ste 100
Auburn, CA 95603-3197
Phone
(530) 885-3951
Fax
(530) 885-3932
NPI assigned
Oct 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032552 CA Primary

Addresses

Primary practice location

13555 Bowman Rd Ste 100
Auburn, CA 95603-3197

Mailing address

13555 Bowman Rd Ste 100
Auburn, CA 95603-3197
Phone (530) 885-3951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250307003002 CA Practitioner - Nurse Practitioner 6406377324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Complete Care IncGroup PAC ID 7113119454, 10 clinicians

Practice addresses (Care Compare)

13555 Bowman Rd
Suite 100
Auburn, CA 95603-3197
Phone 5308853951113

Hospital & facility affiliations

  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95032552CAMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Complete Care, Inc. CurrentSince Dec 13, 2024 Accepting new patients

Locations

13555 Bowman Rd
Ste 100
Auburn, CA 95603
Phone (530) 885-3951

23000 Foresthill Rd
Foresthill, CA 95631
Phone (530) 367-2229

Interoperability endpoints

  • Direct secure messaging: ryan.holt.1@8214.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8214/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

Hospital & facility affiliations 4

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": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1043030455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 BOWMAN RD STE 100",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033197",
            "telephone_number": "530-885-3951",
            "fax_number": "530-885-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 BOWMAN RD STE 100",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033197",
            "telephone_number": "530-885-3951",
            "fax_number": "530-885-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "RYAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.