Individual provider Active NPI

Holly Barnes Ford, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1053060780
Registry record updated Oct 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
53141 Issued in NM
Practice address
1913 Hano Rd
Santa Fe, NM 87505-8750
Phone
(505) 819-8686
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53141 NM Primary
Registered Nurse 163W00000X 53141 NM

Addresses

Primary practice location

1913 Hano Rd
Santa Fe, NM 87505-8750

Mailing address

1502 S Saint Francis Dr
Santa Fe, NM 87505-4040
Phone (505) 409-6351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20221214002554 NM Practitioner - Nurse Practitioner 7214306224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renew Psych Services LLCGroup PAC ID 6406225416, 2 clinicians

Practice addresses (Care Compare)

1502 S Saint Francis Dr
Santa Fe, NM 87505-4040
Phone (505) 409-6351

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Psych Services LLC Psychiatric/Mental Health CurrentSince Nov 1, 2022 Accepting new patients

Locations

1502 S Saint Francis Dr
Santa Fe, NM 87505
Phone (505) 390-6802

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.

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664582400000",
    "number": "1053060780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S SAINT FRANCIS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054040",
            "telephone_number": "505-409-6351",
            "fax_number": "505-557-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 HANO RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875058750",
            "telephone_number": "505-819-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES FORD",
        "first_name": "HOLLY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-10-01",
        "certification_date": "2022-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "53141",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "53141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.