Individual provider Active NPI

Jessica Calista Holly, NP

  • Nurse Practitioner
  • Joplin, MO
National Provider Identifier
1073243226
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023020564 Issued in MO
Practice address
1331 W 32ND St
Joplin, MO 64804-1601
Phone
(417) 347-6737
NPI assigned
Jun 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2023020564 MO Primary

Addresses

Primary practice location

1331 W 32ND St
Joplin, MO 64804-1601

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-3474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230707003472 MO Practitioner - Nurse Practitioner 0648639682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

1331 W 32ND St
Joplin, MO 64804-1601
Phone (417) 347-6767

Hospital & facility affiliations

  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince Jul 3, 2023 Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients

Locations

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

Organizations & group practices 2

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 2

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": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1073243226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041601",
            "telephone_number": "417-347-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLY",
        "first_name": "JESSICA",
        "middle_name": "CALISTA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023020564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.